Children with Asthma: Literature Review


As a rather common respiratory disease, asthma often begins during childhood or adolescence. Corticosteroids represent one of the best options for the treatment of asthma in children because they contribute to the long-term management of the persistent symptoms of this condition. The preferred daily treatment for asthma is inhaled corticosteroids that are administered with the help of inhalers, and the latter only feature smaller dosages of corticosteroids to reduce the occurrence of potential side effects. The existing research suggests that there are issues related to the use of corticosteroids in children. The proposed literature review is going to address the deficiencies in bone formation and potentially adverse side effects that could negatively influence children’s health. The fact that there are specific challenges related to the application of corticosteroids proves that children with asthma represent one of the most vulnerable populations.

Literature Review

Corticosteroids and Bone Fracture

The article written by Gray et al. (2018) dwelled on how children with asthma could be affected by the side effects of corticosteroids. They hypothesized that the increase in bone fractures among the children that intake inhaled corticosteroids could be supported statistically. To test their hypothesis, Gray et al. (2018) went on to validate if the number of corticosteroid prescriptions could hurt children’s health and then compared the obtained data to the children with no recorded use of corticosteroids. The findings presented by the researchers showed that the odds of fracture were much higher in children that filled at least one prescription of corticosteroids during the 1-year lookback period (Gray et al., 2018). Another area addressed by the researchers was the existence of increased exposure to fractures in the children who systemically used corticosteroids.

To achieve the most relevant results, Gray et al. (2018) excluded systemic corticosteroids from the research project and concluded that asthma exacerbations are subject to the largest proportions of corticosteroid usage. Severe asthma in children may be one of the primary causes of fractures, with corticosteroids being the catalyst. The increase in disease severity is explained by the adverse effects of corticosteroids on children’s bodies. The fact that inhaled corticosteroids are not as strong as their systemic counterparts show that the bioavailability of corticosteroids might also be essential when reviewing the negative effect of asthma medications. Gray et al. (2018) explained this link by associating their study with several adult studies where the increased risk of fracture had also been linked to corticosteroids. As a result, the researchers proposed to extend the investigation on the effects of corticosteroids on children by assessing potential risks of oral corticosteroid use.

Corticosteroids in Pediatric Asthma

In the research article written by Hossny et al. (2016), the most common conceptions related to asthma in children were reviewed in rich detail. They highlighted the need for improved care guidelines and found that the majority of asthma control options are suboptimal. Even though inhaled corticosteroids are considered to be one of the most effective options available to suppress asthma-related airway inflammation, there is a gap in the literature that averts researchers from addressing the effectiveness of corticosteroids in children with asthma. The idea is that inhaled medications have to be utilized properly to remain effective (Hossny et al., 2016). To regain control of asthma in children, practitioners have to deliver corticosteroids as appropriately as possible and realize that there are specific intervals that have to be respected if physicians expect to introduce definite treatment strategies based on corticosteroids.

Hossny et al. (2016) proposed to apply the lowest possible dosages to children with asthma to evade situations where young patients would become dose-dependent. There are different types of corticosteroids that children may intake, but concomitant delivery of different types of corticosteroids should be carefully addressed by physicians to evade the majority of adverse effects that corticosteroids might have on children (Hossny et al., 2016). Based on the research completed by Hossny et al. (2016), it may be claimed that inhaled corticosteroids do not represent an efficient method of curing asthmatic children. The lack of continuity in corticosteroid intake might lead to the deterioration of airway responsiveness and lung function. There are many benefits associated with the use of corticosteroids in children with asthma, but it is also crucial to overcome repetitive patterns in patient education.

Discussion and Conclusions

The existing results prove that there are specific implications that might negatively affect the process of implementing corticosteroids in asthma treatment in children. The latter mostly fail to fill inhaled corticosteroid prescriptions during at least one year. Physician-diagnosed asthma has to be treated carefully in order not to affect the objective measures of the pharmacy and make sure that children respond to the treatment adequately. The articles that were published by Gray et al. (2018) and Hossny et al. (2016) suggested that often parental reports or self-reports failed to display the severity of asthma or the effectiveness of corticosteroid usage. This creates room for future studies in the area that would address the impact of self-reports on the treatment of asthma in children. The consistency between the two studies reviewed within the framework of the current paper shows that children with asthma are exposed to multiple adverse effects that cannot be overcome at the moment.


Gray, N., Howard, A., Zhu, J., Feldman, L. Y., & To, T. (2018). Association between inhaled corticosteroid use and bone fracture in children with asthma. JAMA Pediatrics, 172(1), 57-64.

Hossny, E., Rosario, N., Lee, B. W., Singh, M., El-Ghoneimy, D., Soh, J. Y., & Le Souef, P. (2016). The use of inhaled corticosteroids in pediatric asthma: Update. World Allergy Organization Journal, 9(1), 1-24.

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