Abstract
In order to investigate the influence of the revised edition of Japanese Pediatric Guideline for the Treatment and Management of Asthma (JPGL) 2005 on the treatment for pediatric asthma patients, we compared the survey for pediatricians in 2006, one year after the publication of JPGL2005, with that in 2005, just before the publication of JPGL2005. A scoring system was introduced to correct some problems that the questionnaires had included, and the survey in 2003 was also referred to.
Regarding the treatment for acute asthma exacerbations, fewer pediatricians selected intravenous xanthines, while the use of systemic steroids increased. Continuous nebulizations of isoproterenol for severe attacks and mechanical ventilations with intratracheal intubations for respiratory failure also increased. Those changes were stronger from 2005 to 2006 than those from 2003 to 2005, clearly indicating the influence of JPGL2005 on the treatment for acute asthma attacks.
As for the controller medications, a decrease in sustained release theophyllines and an increase in inhaled cortico-steroids were observed after the publication of JPGL2005. On the other hand, leukotriene receptor antagonists had already increased before JPGL2005 was published.
This study showed the strong influences of JPGL2005 on asthma treatment in children, although JPGL2005 still has many problems. As well as the further diffusion of JPGL, further improvement is necessary.
