NHG-standaard ‘Astma bij kinderen’

• In children < 6 years characteristic asthma patterns are often lacking and the diagnosis cannot be objectified. For this reason ‘episodic expiratory wheezing’ is the preferred diagnosis.
• In children ≥ 6 years asthma is diagnosed on the basis of symptoms; if there is doubt spirometry may be helpful.
• The treatment goal is complete asthma control, i.e. daytime symptoms < 2/week, no nocturnal symptoms, no limitation of activities, rescue treatment ≤ 2/week, normal spirometry.
• Smoking by children or relatives is strongly discouraged.
• In children < 1 year, a monitored trial with short-acting beta-agonist (SABA) is recommended. Controller medication (inhaled corticosteroids (ICS)) is not recommended.
• In children aged 1 to 6 years, a SABA is recommended, with additional ICS if symptoms persist. Incompletely controlled asthma is an indication for referral.
• In children ≥ 6 years ICS are recommended in incomplete asthma control. If the normal daily dosage of ICS and adequate coping fail to achieve complete control of the asthma, then referral is recommended.
• Patients on ICS should be monitored regularly.

Conflict of interest and financial support: none declared.