Special problems in the management of chronic asthma in children.

Children with asthma may be misdiagnosed when they present with chronic cough or wheezing following an upper respiratory infection. Such children are more appropriately treated with bronchodilators than with antibiotics and cough medicine. Failure to recognise these presentations of childhood asthma often lead to its increased morbidity. Inappropriate bronchodilator therapy and the failure to consider prophylactic drugs are common causes of poor control of childhood asthma. Wherever possible, the beta 2-sympathomimetics should be prescribed in the inhaled form. The inhalation methods and devices employed should be appropriate for the age of the child. Steroids are often necessary for good control in children with chronic asthma. Fear of their systemic side-effects may delay their use. These side-effects can be avoided if the inhaled beclomethasone dipropionate is used. The majority of chronic asthmatic children will improve with beclomethasone dipropionate without the need for additional oral steroids. It is important to note that successful management of childhood asthma does not only depend on the appropriate use of drugs but also the education of the child and parents on asthma.