According to the WHO, asthma is the most common chronic disease in children
Clinically it manifests as recurrent episodes of wheezing, dyspnoea, chest tightness and cough
Episodes are associated with variable airflow obstruction that is usually reversible
Children < 12 months of age presenting with wheeze are likely to have bronchiolitis, which will not respond to bronchodilators. See bronchiolitis guideline
Inhaled corticosteroids (ICS) on discharge
Who to start ICS on discharge:
Children who present with asthma
Children with > 3 preschool wheeze episodes
What dose?
>6 years: start dose Becotide 100 BD, ↑ to 200 BD if already taking ICS
2-6 years: Becotide 50 or 100, one puff twice daily
How long?
In asthma, continue ICS long term. Review treatment with GP and/or Paediatrician at least once a year
In preschool wheeze, prescribe ICS for 3 months and assess response, stop if no benefit. Even if benefit, many children can also stop ICS in Spring time if viral infections are a predominant trigger as many pre-schoolers stop wheezing with viruses as they get older