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Asthma - Management
How should I manage children with an intermediate probability of asthma who cannot perform airway obstruction tests?
- The following options may be tried depending on the frequency and severity of symptoms:
- Watchful waiting — review the child after an interval agreed with the parents or carers.
- Start a trial of asthma treatment for 2–3 months. The choice of treatment depends upon the severity and frequency of symptoms:
- If response is good, continue treatment.
- If response is poor, assess compliance and inhaler technique, and consider referral to secondary care for additional tests.
- If it is unclear whether a child has improved, careful observation during a trial of treatment withdrawal may clarify whether they have responded to asthma treatment.
Clarification / Additional information
- Watchful waiting with review: in children with mild, intermittent wheeze and other respiratory symptoms which occur only with viral upper respiratory tract infections, it is reasonable to give no specific treatment and then review the child.
Basis for recommendation
- These recommendations are based on the British Guideline on the Management of Asthma: a national clinical guideline [SIGN and BTS, 2009]:
- Measuring lung function in young children is difficult and not usually possible in children younger than 5 years of age.
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