Skip to main content

Table 1 Summary of the stepwise approach for managing asthma in children less than 5 years of age according to different guidelines

From: Treatment of asthma in young children: evidence-based recommendations

 

NAEPP [31]

British [32]

GINA [33]

Canadian [34]

Step 1

SABA prn

SABA prn

SABA prn

SABA prn

Step 2

Pref: Low-dose ICS

Pref: ICS 200–400 μg /daya,b

Pref: Daily low-dose ICS

Pref: Daily low-dose ICS

Alter: cromolyn or LTRA

Alter: LTRA

Alter: LTRA or intermittent ICS

Alter: LTRA

Step 3

Medium-dose ICS

ICS + LTRA

Pref: Double low-dose ICS

Medium-dose ICS

Alter: Low-dose ICS + LTRA

Step 4

Medium-dose ICS + either LABA or LTRA

Refer to respiratory pediatrician

Pref: Continue controller & refer for specialist assessment

Referral to asthma specialist

Alter: Add LTRA, increase ICS frequency, intermittent ICS.

Step 5

High-dose ICS + either LABA or LTRA

   

Step 6

High-dose ICS + either LABA or LTRA

   

Consider OCS

  1. Alter alternative, GINA Global Initiative for Asthma, ICS inhaled corticosteroids, LABA long active beta-2 agonists, LTRA leukotriene receptor antagonist, NAEPP National Asthma Education and Prevention Program, OCS oral corticosteroids, Pref preferred, prn pro re nata, SABA short active beta-2 agonist
  2. abeclometasona dipropionate or equivalent doses
  3. bHigher nominal doses may be required if drug delivery is difficult