Pharmaceutical treatment strategies for childhood asthma

PURPOSE OF REVIEW: Although great improvement has been obtained in quality of life and mastering of illness by asthmatic children over recent decades, controversies still exist related to asthma treatment. The objective of the present article is to discuss such controversies. RECENT FINDINGS: Results from recent publications related to childhood asthma treatment question existing dogmas. Important for prescribing correct treatment to children is correct diagnosis. Phenotypes of childhood asthma related to treatment decisions are discussed. Early use of inhaled steroids in young children is still debated as well as the preference of inhaled long-acting beta2-agonists versus leukotriene receptor antagonists as add on to inhaled steroids. When present, both allergic rhinitis and asthma should be treated to obtain improved control. Also as regards the treatment of exercise-induced asthma in children, new results concerning use of leukotriene receptor antagonists is discussed as well as the acute treatment in infants with bronchial obstruction. SUMMARY: There are still several controversies regarding treatment of the asthmatic child. New studies designed specifically for children are needed to solve these questions. One cannot rely on studies performed in adults for treatment in children. New studies designed for childhood asthma are needed to solve these controversies.