Continuing Medical Education

Management of asthma exacerbations in children

S Kling, D A White


Asthma exacerbations are episodes of worsening asthma symptoms with shortness of breath, cough, wheeze and/or tight chest that require an increase in asthma treatment. A major change in the recommendations for managing mild asthma exacerbations is the move away from using inhaled short-acting beta-2 agonists (SABAs) as the sole reliever, toward a combination of a rapid-onset, long-acting beta-2 agonist, formoterol, in combination with an inhaled corticosteroid (ICS), or a SABA used together with an ICS in separate inhalers, in older children and adolescents. In children <11 years of age who are adherent to daily ICS treatment, the ICS dose should not be increased short term. A written asthma plan should include instructions on how to self-manage asthma exacerbations, and when to present to a medical facility. Oxygen is an essential component of the management of asthma exacerbations at both primary care and emergency department facilities, together with inhaled SABAs via metered-dose inhaler and spacer, and oral corticosteroids.

Authors' affiliations

S Kling, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

D A White, Charlotte Maxeke Johannesburg Academic Hospital and Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

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Asthma; Asthma exacerbations; Acute asthma; Children

Cite this article

South African Medical Journal 2021;111(8):710-713. DOI:10.7196/SAMJ.2021.v111i8.15853

Article History

Date submitted: 2021-08-02
Date published: 2021-08-02

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