Practical recommendations for home-nebulized corticosteroid use in children aged ≤ 5 years with asthma: A review and advisory group consensus
Issued Date
2025-06-01
Resource Type
ISSN
0125877X
Scopus ID
2-s2.0-105011288042
Pubmed ID
37466961
Journal Title
Asian Pacific Journal of Allergy and Immunology
Volume
43
Issue
2
Start Page
266
End Page
280
Rights Holder(s)
SCOPUS
Bibliographic Citation
Asian Pacific Journal of Allergy and Immunology Vol.43 No.2 (2025) , 266-280
Suggested Citation
Direkwattanachai C., Deerojanawong J., Aksilp C., Jirapongsananuruk O., Kamalaporn H., Kamchaisatian W., Lochindarat S., Ngamtrakulpanit L., Poachanukoon O., Lao-Araya M., Teeratakulpisarn J., Udomittipong K., Vangveeravong M., Ruangnapa K., Chatchatee P. Practical recommendations for home-nebulized corticosteroid use in children aged ≤ 5 years with asthma: A review and advisory group consensus. Asian Pacific Journal of Allergy and Immunology Vol.43 No.2 (2025) , 266-280. 280. doi:10.12932/AP-180222-1335 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/111426
Title
Practical recommendations for home-nebulized corticosteroid use in children aged ≤ 5 years with asthma: A review and advisory group consensus
Author's Affiliation
Thammasat University
Siriraj Hospital
Faculty of Medicine, Chiang Mai University
Ramathibodi Hospital
Faculty of Medicine, Khon Kaen University
Thailand Ministry of Public Health
Faculty of Medicine, Chulalongkorn University
Faculty of Medicine, Prince of Songkla University
Bangkok Hospital Medical Center
Bangkok Children's Hospital
Siriraj Hospital
Faculty of Medicine, Chiang Mai University
Ramathibodi Hospital
Faculty of Medicine, Khon Kaen University
Thailand Ministry of Public Health
Faculty of Medicine, Chulalongkorn University
Faculty of Medicine, Prince of Songkla University
Bangkok Hospital Medical Center
Bangkok Children's Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
BACKGROUND: Despite nebulized budesonide being identified by the Global Initiative for Asthma report as a viable alternative to inhaled corticosteroids (ICS) delivered by pressurized metered-dose inhalers (pMDIs) with spacers, practical guidance on nebulized corticosteroid use in the pediatric population remains scarce. OBJECTIVE: To review the current literature and provide practical recommendations for nebulized budesonide use in children aged ≤ 5 years with a diagnosis of asthma. METHODS: A group of 15 expert pediatricians in the respiratory and allergy fields in Thailand developed Delphi consensus recommendations on nebulized budesonide use based on their clinical expertise and a review of the published literature. Studies that evaluated the efficacy (effectiveness) and/or safety of nebulized budesonide in children aged ≤ 5 years with asthma were assessed. AR patients. RESULTS: Overall, 24 clinical studies published between 1993 and 2020 met the inclusion criteria for review. Overall, results demonstrated that nebulized budesonide significantly improved symptom control and reduced exacerbations, asthma-related hospitalizations, and the requirement for oral corticosteroids compared with placebo or active controls. Nebulized budesonide was well tolerated, with no severe or drug-related adverse events reported. Following a review of the published evidence and group consensus, a treatment algorithm as per the Thai Pediatric Asthma 2020 Guidelines was proposed, based on the availability of medications in Thailand, to include nebulized budesonide as the initial treatment option alongside ICS delivered by pMDIs with spacers in children aged ≤ 5 years. CONCLUSIONS: ThNebulized budesonide is an effective and well-tolerated treatment option in children aged ≤ 5 years with asthma.