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Asthma - Management
Which delivery system is recommended for children younger than 5 years?
- A pressurized metered-dose inhaler (pMDI) plus suitable spacer device, with a face mask where necessary, is recommended for the delivery of inhaled corticosteroid and bronchodilators in children younger than 5 years.
- If this is not clinically effective for the child, consider nebulized therapy. Few children younger than 5 years can use a dry-powder inhaler adequately.
Clarification / Additional information
- A face mask is required until the child can breathe reproducibly using the spacer mouthpiece [SIGN and BTS, 2009]. Most children older than 3 years can use a mouthpiece.
Basis for recommendation
- These recommendations are based on the National Institute for Health and Clinical Excellence, Guidance on the use of inhaler systems in children under the age of 5 years with chronic asthma, and are based on limited evidence from small, poor-quality studies [NICE, 2000].
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