Stepping up asthma therapy in children

If asthma remains partially or poorly controlled after 4 to 6 weeks of treatment, consider stepping up therapy.

Before increasing therapy, review adherence and inhaler technique, and check equipment (inhaler, spacer, mask) for breakage or blockage. Ensure exposure to triggers is minimised, and assess for symptoms or signs that could indicate an alternative diagnosis or a comorbidity that could reduce asthma control (eg allergic rhinitis). Poor response to therapy (particularly to correctly used inhaled corticosteroid [ICS]) could indicate that the diagnosis of asthma is incorrect. Most children with asthma can achieve good control with Step 2 therapy.