Paediatric asthma guidelines

摘要

The first British guidelines on asthma management were produced in 1990 but were only applicable to adults The first revision of these was published in 1993 and included guidelines for children as did the subsequent review (Review and Position Statement) published in Thorax in 1997,' On reflection it is interesting to note that in the 1993 guidelines the dose of inhaled corticosteroids (ICS) recommended at Step 3 was 400 (xg/day for children of school age The 1997 guidelines, following much pressure from certain adult chest physicians, recommended that school children and adults with chronic asthma should be treated in a similar fashion and at Step 3 the dose of ICS was recommended as 800-2000 |j,g/day The result of these guidelines was that children of all ages were commenced on very high doses of ICS, much higher than those used and recommended in other countries, and without any supportive evidence base whatsoever The British Paediatric Respiratory Society (BPRS) and the R6'yal College of Paediatrics and Child Health were therefore very keen to be involved in the development of the 2003 British guidelines on the management of asthma to redress the above and to make pertinent statements about asthmatic children, highlighting the major differences from asthmatic adults.