The international consensus report on diagnosis and treatment of asthma: a call to action for US practitioners.

Effective management of asthma requires accurate diagnosis and assessment of the severity of the disease. Subjective measures, such as the degree of cough, wheezing, and chest tightness, and objective assessments of pulmonary function, provide diagnostic evidence of the presence of asthma. The diagnostic criteria included in the International Consensus Report on Diagnosis and Treatment of Asthma provide one method of classifying asthma by the degree of severity. These guidelines, which were developed by the National Institutes of Health in collaboration with the International Asthma Management Project, include the US Guidelines for the Diagnosis and Management of Asthma. Only the mildest, intermittent cases of asthma generally can be managed with an inhaled short-acting beta 2-agonist given alone as needed. As the frequency or severity of the asthma increases, inhaled corticosteroids, inhaled cromolyn, or inhaled nedocromil should be added to the treatment regimen. Sustained-release theophylline, long-acting oral or inhaled beta 2-agonists, and inhaled anticholinergic agents also have a place in the treatment of selected patients.