Asthma in Children Aged 6–11 Years: What to Do When Step 1 Treatment Has Not Achieved Control
In children aged 6 to 11 years with asthma, a first-line regimen is not always sufficient to reach full asthma control. When Step 1 fails to deliver the expected outcomes, a structured next-line protocol is indicated.
Patient group: Children aged 6–11 years with asthma. Children in this age group should not be managed with reliever therapy alone — a regimen that includes inhaled corticosteroid-containing treatment is required at every step.
Why Step 1 Has Led to This Point
Step 1 treatment — short-acting beta2-agonist used as needed, with a low dose of inhaled corticosteroid taken at the same time — did not achieve the following goals:
- No troublesome asthma symptoms during the day or night
- No severe asthma exacerbations
- Normal or near-normal lung function
- Ability to lead a fully active life
A next-line protocol is now appropriate for this child.
Next-Step Treatment Approach
This protocol moves to a daily inhaled corticosteroid taken on a regular schedule — a shift away from as-needed-only use — with a reliever available for breakthrough symptoms. The complete regimen, including the specific structure and criteria, is in the full protocol.
Treatment Goals
The aim is well-controlled asthma: no troublesome daytime or night-time symptoms, no severe exacerbations, normal or near-normal lung function, and the ability to participate fully in active life.
References
Children aged 6–11 years with asthma should not be treated with SABA alone; they should all receive ICS-containing treatment.
In Step 2, the child takes a low total dose of ICS every day, plus SABA as needed for symptoms.
'Well-controlled asthma' means that the person does not have severe asthma exacerbations, they do not have troublesome asthma symptoms during the day or night, they have normal lung function or almost normal lung function, and they are able to lead active lives, including exercise.
View source ↗