Optimal management of preschool asthma

Asthma is common in most parts of the world and remains the most common single reason preschool aged children are admitted to hospital in developed countries. In determining what the optimal management of preschool asthma is, several factors must be considered, including: the aims of treating preschool asthma; which children require treatment; and what treatment is effective. The most controversial aspects of treating preschool asthma relate to maintenance treatment. Guidelines for managing asthma in children have been developed; however, the relative lack of appropriate clinical trials in preschool children is a problem. Prolonged treatment with inhaled corticosteroids controls asthma during treatment but has no disease-modifying effects. Intermittent treatment with inhaled corticosteroids initiated at the onset of asthma-like symptoms and continued for short periods is ineffective. Short-term treatment with leukotriene receptor antagonists provides symptomatic relief but evidence for long-term efficacy is lacking. Further data are needed to determine optimal asthma management in preschool children.