Management of asthma: a consensus statement.

Abstract

Management of asthma: a consensus statement SIR,-I wish to comment on the management of asthma in the first year of life reported in the recent consensus statement.'It is un- fortunate that such reports do not supply references for their contentions nor do they indicate where serious differences of opinion exist.In particular I would challenge the state- ment that the more troublesome children under 1 year should be given oral 2-stimu- lants and/or oral xanthines.As far as I am aware there is no evidence that these drugs are of benefit in children under 1 year and two authors of the report have assessed this.In view of the known side effects of these drugs, it seems ill advised to recommend them when they are of no proven benefit and the balance of the literature suggests they may be harmful.While some studies have found a benefit from nebulised ipratropium bromide in infancy others have not.Similarly there are studies which cannot find any response to cor- ticosteroids.There is in fact a quite sustainable argument that no drug treatment should be offered to the wheezing infant and that we should con- centrate on the prevention or treatment of dehydration and giving oxygen when anoxia occurs.