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[Guideline on diagnosis and treatment: bronchial asthma in children ≥ 6 years old. Update 2021]
Insights
The updated childhood asthma guidelines emphasize new therapeutic strategies, moving away from on-demand bronchodilators. Intermittent inhaled corticosteroids and long-acting bronchodilators are now options for milder asthma in older children.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Clinical Guidelines
Background:
- The Guideline on Diagnosis and Treatment for Childhood Asthma was first published in 1995, with subsequent updates in 2007 and 2016.
- This document presents new content after a 5-year interval, focusing on advancements in pediatric asthma management.
Purpose of the Study:
- To present the updated Guideline on Diagnosis and Treatment for Childhood Asthma.
- To highlight significant modifications in therapeutic strategies for pediatric asthma.
Main Methods:
- The guideline updates incorporate current evidence and expert consensus on asthma diagnosis and treatment.
- Treatment is now stratified into five distinct levels (1 to 5).
Main Results:
- A key change is the eradication of on-demand prescription of bronchodilators (salbutamol).
- Intermittent treatment with inhaled corticosteroids plus long-acting bronchodilators (LABA) is introduced for milder asthma (levels 1 and 2) in children over 12 years old.
- Evidence for these new options in children under 12 years old is insufficient, maintaining previous recommendations for this age group.
Conclusions:
- The updated guidelines introduce a stratified treatment approach for childhood asthma.
- New therapeutic options, including intermittent inhaled corticosteroids and LABA, are recommended for specific pediatric populations.
- Further research is needed to support these interventions in younger children.
Abstract:
In 1995, the first Guideline on Diagnosis and Treatment for Childhood Asthma was published in Archivos Argentinos de Pediatría. Updates were made in 2007 and 2016. After 5 years, the new contents are presented. The most relevant modifications, although not the only ones, are observed in therapeutic strategies. In this version, treatment is stratified into "levels" (1 to 5). The current paradigm of change in chronic asthma treatment consists in eradicating the prescription of bronchodilators (salbutamol) on demand. Besides that, the option of intermittent treatment with inhaled corticosteroids plus long-acting bronchodilators (LABA) appears for milder forms (levels 1 and 2) in children > 12 years old. There is still not enough evidence to support these options in<12 years old maintaining the previous recommendations in this group. For more details we suggest reading the full document.
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