Primary Care Management of Children with Bronchial Asthma: The Role of Inhaled Glucocorticoids

Studies show that 75% of all asthma-related office visits for patients under the age of 18 are made to primary care clinicians (family practice physicians and/or pediatricians). These caregivers have traditionally been reluctant to employ corticosteroids or inhaled glucocorticoids for pediatric patients, but accepted pharmacotherapy for children now includes the use of inhaled glucocorticoids for moderate to severe asthma. This recommendation has been set by the National Heart, Lung and Blood Institute's Guidelines for the Diagnosis and Management of Asthma, with input from the American Academy of Pediatricians, among others. This paper documents special considerations for pediatric patients with asthma and is designed to help the practitioner reach a correct differential diagnosis and categorization, and to institute appropriate therapy.