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[Treatment of childhood asthma]
1Service de Pédiatrie et Pneumologie de l'Enfant, Hôpital Trousseau, Paris.
Insights
Early and individualized treatment of childhood asthma, addressing both acute episodes and chronic management, is crucial. Tailoring interventions to age, severity, and triggers like allergies or infections improves outcomes and prevents long-term disease progression.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Respiratory Medicine
Context:
- Childhood asthma requires a multifaceted treatment approach.
- Early intervention is key to preventing disease chronicity.
- Asthma management must consider individual patient factors.
Purpose:
- To outline comprehensive treatment strategies for childhood asthma.
- To differentiate between acute and chronic asthma management.
- To emphasize the importance of etiology-specific treatments.
Summary:
- Acute asthma episodes are treated with bronchodilators (BD), potentially corticosteroids, and antibiotics if infection is suspected.
- Chronic management involves symptomatic relief with BDs and corticosteroids, tailored to frequent exacerbations.
- Addressing the underlying etiology includes allergen avoidance, medications like disodium cromoglycate, physiotherapy, and managing infectious or psychosomatic factors.
Impact:
- Early and appropriate diagnosis and treatment significantly improve childhood asthma prognosis.
- Preventing disease progression avoids long-term respiratory complications.
- Personalized treatment plans enhance patient quality of life and reduce healthcare burden.
Abstract:
The treatment of childhood asthma should be considered with respect to age, severity and aetiology. Treatment should be instituted early from the first crisis in order to avoid progression to a more severe form. It consists of two aspects: the treatment of the acute episode and the chronic treatment. The treatment of the acute episode consists of using bronchodilators (BD) (rapid release Theophylline and/or beta agonists) to which one might add corticosteroids if the crisis lasts for more than a few hours or seems severe at the outset, an antibiotic should also be used as infection is often a trigger factor in infants. Maintenance treatment is necessary in asthmatics with frequent exacerbations. It should be tailored to the symptomatology and aetiology. The symptomatic treatment consists of a bronchodilator (slow release Theophylline or an atropine-like pharmacological derivative) to which one may add, in severe cases, corticosteroids which may be in the form of aerosol, or as rarely as possible by mouth. The second aspect of treatment relating to the aetiology is the most difficult to apply as childhood asthma is often multi-factorial: in allergic asthma the avoidance of allergens, disodium cromoglycate, ketotifen, and if necessary specific desensitization. In non-allergic asthma, physiotherapy, treatment of infectious foci, particularly ENT (ORL), and attention to psychosomatic features. When asthma is diagnosed and treated early the prognosis is transformed and progress towards chronicity is avoided.