Severe childhood asthma: a common international approach?

Abstract

Although most children with asthma are easy to treat with low doses of safe drugs, many remain symptomatic despite every effort.1 The nomenclature for this group is confused, and studies are difficult to compare because of the proliferation of terms that describe poorly defined clinical entities. To clarify, we propose the term problematic asthma to describe children with chronic symptoms or acute severe exacerbations, or both, despite prescription of multiple drugs. Such therapies usually include high doses of inhaled or oral corticosteroids, combined with standard add-on therapy with long-acting β2 agonists (leukotriene-receptor antagonists and theophylline).