Inhaled corticosteroids in childhood asthma.

Practitioners prescribing inhaled corticosteroids for children need to be aware of the potential for systemic side effects, particularly in relation to effects on growth, bone metabolism and adrenal function. There is a need for further long-term studies to assess the risk of side effects especially in younger children. Until further data are available, caution is required in transposing current safety data from adults and older children to the very young. Precise safety thresholds cannot be defined at present. The risk-benefit ratio of corticosteroids must be assessed for each patient and reassessed at intervals during continuing therapy. Strategies to decrease the dose and minimise the potential for systemic side effects should be a routine part of asthma management. Concern about potential side effects should not outweigh the need for effective symptomatic control. Children with asthma should not be exposed to the risks of either under treatment or overtreatment of their asthma.