Update in paediatric asthma management: Where is evidence challenging current practice?

Abstract

Extrapolation of management strategies based on results from predominantly adult asthma studies frequently occurs in paediatric asthma despite increasing evidence that paediatric asthma and, in particular, pre-school recurrent wheeze are very different disease entities. Response to medications in paediatric subjects is often different from that seen in their older adolescent and adult counterparts. In this update, we discussed recent studies that have had important implications for future paediatric asthma management. The overuse of combination inhaled steroid and long-acting beta2 agonist inhalers in paediatric asthma despite ongoing safety concerns is an increasing trend in paediatric asthma, and recent evidence has helped clarify how they should be used in children. Other aspects discussed include the role of oral corticosteroids in pre-school viral-induced wheeze and the utility of leukotriene receptor antagonists in exercise-induced asthma.

Infectious morbidity and resource use in children under 2 years old at childcare centres

“…In the study by Hatakka et al ., breastfeeding demonstrated a protective role, which was not significant in our sample, perhaps because the distribution of breastfeeding was homogeneous in the two groups, or perhaps due to the applied cut‐off of 4 or 6 months of breastfeeding (4 months in our study). Recurrent wheezing, particularly in pre‐schoolers, constitutes a clinical entity with its own characteristics, not comparable with asthma in adults . The prevalence of recurrent wheezing in Europe is 15% during the first year of life, according to an international study on breastfed babies .…”

“…Recurrent wheezing, particularly in pre-schoolers, constitutes a clinical entity with its own characteristics, not comparable with asthma in adults. 26 The prevalence of recurrent wheezing in Europe is 15% during the first year of life, according to an international study on breastfed babies. 27 In our setting, the prevalence of recurrent wheezing is between 18 and 33% of all children in the first 3 years of age.…”

Physical Activity in School-Aged Children with Asthma in an Urban City of Taiwan

“…4 The maintenance of normal function allowing asthmatic children to participate fully in physical activities is one of the goals of modern asthma management. 5 Physical activity is important for the development of good health and fitness habits in children, 6,7 and participation in physical activity is an important part of children's normal psychosocial development and self-image. 8,9 It has been considered that the physical activity level in children with asthma is limited in comparison to their peers.…”

Acronyms Confuse Everyone: Combating the use of acronyms to describe paediatric research studies

“…As medical ethicists and members of the A cronym S uppression S ociety ( ASS ), the authors have observed a practice among researchers to entitle their research proposals with acronyms. Our attention to this was stimulated by a recent review paper on paediatric asthma that referenced several studies described by acronyms including SMART, PEAK and BEST …”