Recommendations for Treatment for Intermittent Mild Persistent Astma in Children and Adolescents
author: Prof. Gerd J Cropp M.D.,Ph.D. croppgj@msn.com UCSF Pediatrics [415-476-2072] 521 Parnassus Avenue Suite#C344 San Francisco California United States 94143-0632; Prof. Charles K. Naspitz charles@naspitz.com.br Federal University,Sao Paulo Pediatrics Sao Paulo Brazil
language: en

Abstract

Many parents and caretakers of children and adolescents with mild persistent asthma (MPA) do not follow proposed guidelines, namely the daily and continuous administration of inhaled corticosteroids (ICS). Instead, parents and caretakers tend to use ICS and bronchodilators intermittently for short periods and re-start such therapy only when symptoms reappear. It is our opinion that intermittent treatment of MPA in children and adolescents might achieve the same level of asthma control as has been achieved in adults. We propose, therefore, that after an initial period of stabilization with age-appropriate doses of oral glucocorticoids or high-dose ICS and short-acting beta-2 agonists (SABA), caretakers can stop treatment once there are no longer signs or symptoms of asthma. When asthmatic symptoms recur, treatment should be restarted with ICS and SABA, or oral corticosteroids if the exacerbation is severe. The perception of developing asthma symptoms remains an unsolved problem. Based on our clinical experience with asthmatic children and adolescents, we list a number of signs and symptoms that precede an exacerbation of asthma, allowing for an early re-introduction of treatment to prevent an exacerbation.