• Thomas J Kallstrom.
• Respiratory Care Services, Fairview Hospital, Cleveland OH 44111, USA. tom.kallstrom@fairviewhospital.org.
• Resp Care. 2004 Jul 1;49(7):783-92.

AbstractIn 2002 the National Asthma Education and Prevention Program published evidence-based guidelines for the diagnosis and management of asthma, but there are some unresolved asthma-management issues that need further research. For asthmatic children inhaled corticosteroids are more beneficial than as-needed use of beta(2) agonists, long-acting beta(2) agonists, theophylline, cromolyn sodium, nedocromil, or any combination of those. Leukotriene modifiers are an alternative but not a preferred treatment; they should be considered if the medication needs to be administered orally rather than via inhalation. Cromolyn sodium and nedocromil are effective long-term asthma-control medications, but they are not as effective as inhaled corticosteroids. There is insufficient evidence to determine whether cromolyn benefits maintenance of childhood asthma. Cromolyn sodium and nedocromil are alternatives, but not preferred treatments for mild persistent asthma. Cromolyn may be useful as a preventive therapy prior to exertion or unavoidable exposure to allergens. Regular inhalation of corticosteroids controls asthma significantly better than as-needed beta(2) agonists. No studies have examined the long-term impact of regular inhaled corticosteroids on lung function in children

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