Which statement is most accurate about inhaled corticosteroids in pediatric asthma?

Which statement is most accurate about inhaled corticosteroids in pediatric asthma?

• A. Oral thrush is a common complication of inhaled corticosteroid use
• B. Spacers are not usually necessary for the proper administration of inhaled corticosteroids with a metered dose inhaler
• C. Daily inhaled corticosteroids are most effective in patients with mild intermittent asthma
• D. Inhaled corticosteroids are indicated only for treatment of acute asthma exacerbations

Answer: (A)

Inhaled corticosteroids are the main daily controller therapy for pediatric asthma, and a key local side effect involves the mouth and throat. When the medicine deposits there, it can suppress local immunity enough to allow Candida (oral thrush) to grow. This risk is reduced by rinsing the mouth after each inhaled dose and by delivering the medication through a spacer with a metered-dose inhaler, which lowers oropharyngeal deposition and delivers more of the drug to the lungs. That makes the statement about oral thrush being a common complication accurate. Spacers are typically recommended because they improve the amount of medication reaching the lungs and decrease deposition in the mouth, so the idea that spacers are not usually necessary is incorrect. Daily inhaled steroids are most effective for persistent rather than mild intermittent asthma, so using them only for mild intermittent symptoms isn’t appropriate. And inhaled corticosteroids are not reserved for acute asthma attacks; they are long-term controllers, with rescue inhalers used for immediate relief during exacerbations.

Inhaled corticosteroids are the main daily controller therapy for pediatric asthma, and a key local side effect involves the mouth and throat. When the medicine deposits there, it can suppress local immunity enough to allow Candida (oral thrush) to grow. This risk is reduced by rinsing the mouth after each inhaled dose and by delivering the medication through a spacer with a metered-dose inhaler, which lowers oropharyngeal deposition and delivers more of the drug to the lungs. That makes the statement about oral thrush being a common complication accurate.

Spacers are typically recommended because they improve the amount of medication reaching the lungs and decrease deposition in the mouth, so the idea that spacers are not usually necessary is incorrect. Daily inhaled steroids are most effective for persistent rather than mild intermittent asthma, so using them only for mild intermittent symptoms isn’t appropriate. And inhaled corticosteroids are not reserved for acute asthma attacks; they are long-term controllers, with rescue inhalers used for immediate relief during exacerbations.