This protocol covers children aged 6 to 11 years with asthma whose current regimen has not brought their disease under adequate control, and outlines the structured approach for the next treatment step.
The child is aged 6 to 11 years with a diagnosis of asthma. Children in this age group should not be managed with a short-acting beta2-agonist alone — all require ICS-containing treatment to achieve adequate control.
The child has been on Step 2: a low total daily dose of inhaled corticosteroid every day, plus short-acting beta2-agonist as needed for symptoms. The target — well-controlled asthma with no troublesome daytime or night-time symptoms, no severe exacerbations, and normal or near-normal lung function — has not been met. This protocol describes the next step taken after that failure.
Well-controlled asthma: no troublesome asthma symptoms during the day or night, no severe asthma exacerbations, normal or almost normal lung function, and ability to lead an active life.
Step 3 moves to more intensive inhaled corticosteroid-based regimens. Options include approaches that add a long-acting bronchodilator alongside daily ICS, as well as an approach in which the same inhaler serves for both daily maintenance and as-needed symptom relief. The full set of options, selection criteria, and sequencing is available in the complete protocol.