De standaard 'Astma bij kinderen' (tweede herziening) van het Nederlands Huisartsen Genootschap; reactie vanuit de kinderpulmonologie

- The second revised guideline ‘Asthma in children’ from the Dutch College of General Practitioners provides a well-documented and useful overview. Diagnostic recommendations depend heavily on the symptom ‘wheezing’, which may be difficult to detect in young children. A uniform therapeutic approach for the various asthma phenotypes is recommended, including a therapeutic trial with inhaled corticosteroids for persistent symptoms. Pitfalls include the fact that inhalation of corticosteroids is sometimes difficult in young children, and that the use of corticosteroids in children with transient virus-induced wheeze is not evidence-based. The guideline no longer recommends the use of cromoglycate. Children who are refractory to inhaled steroids should be referred to a paediatrician before trying long-acting β₂-sympathomimetics or leukotriene antagonists. The current challenge is to effectively incorporate this new guideline into a coherent system of care for the asthmatic child in cooperation with paediatricians, asthma nurses and others involved in the diagnosis and treatment of childhood asthma.

Ned Tijdschr Geneeskd. 2008;152:543-5