Debate: Intermittent use of inhaled corticosteroid as the long-term treatment for children with mild asthma. Cons.

Abstract

Inhaled corticosteroid (ICS) is the cornerstone of treatment in the long-term management of childhood asthma. Recent studies showed that intermittent use of ICS was as effective as daily use of ICS for treatment of mild asthma, and that long-term usage of ICS resulted in the reduction in growth. From these data, intermittent use of ICS seems an attractive alternative for treatment of mild intermittent asthma.
However, even though the initial decrease in attained height associated with the use of ICS persisted as a reduction in adult height (approximately 1 cm), the decrease was not progress or cumulative. Although there was no significant difference in the rate of asthma exacerbations between intermittent and daily use of ICS, daily ICS was superior to intermittent ICS in increasing asthma-free days. Furthermore, it is hard to distinguish intermittent from persistent asthma only by symptom patterns.
Up to now intermittent use of ICS is not recommended for treatment of children with mild asthma.