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Treatment escalation for children with exacerbations of asthma—what works? An overview of Cochrane Reviews
  1. Marianne Jenkins1,2
  1. 1Acute Child Health, Cardiff and Vale University Health Board, Cardiff, UK
  2. 2School of Healthcare Sciences, Cardiff University, Cardiff, UK
  1. Correspondence to Mrs Marianne Jenkins, Acute Child Health, Cardiff and Vale University Health Board, Cardiff, UK; mariannejenkins{at}btinternet.com

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Commentary on: Craig SS, Dalziel SR, Powell CVE, et al. Interventions for escalation of therapy for acute exacerbations of asthma in children: an overview of Cochrane Reviews. Cochrane Database Syst Rev; 2018(3): Published 2018 Mar 9. doi:10.1002/14651858.CD012977.

Implications for practice and research

  • The authors acknowledge a lack of comparative studies regarding treatment options therefore recommendations to change practice should be applied with caution. Intravenous magnesium sulphate appears to reduce length of inpatient stay.

  • No evidence that any treatments reduce risk of intensive care admission.

  • Need to develop internationally agreed outcome measures for future trials.

  • Need multicentred trials on second-line therapies with separate focus on preschool children with wheeze.

Context

Exacerbation of asthma is one of the most common reasons for children to attend an emergency department. Children generally respond well to first-line treatments such as inhaled short-acting β-agonists and …

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Footnotes

  • Twitter @mrsjenkins3

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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