Efficacy and safety of inhaled corticosteroids in combination with a long-acting beta2-agonist in asthmatic children under age 5.

The incidence of asthma in children under age 5 is higher than in any other segment of the population. Current NAEPP guidelines recommend treatment of some asthmatics in this age group with the combination of an inhaled corticosteroid and a long-acting beta2-agonist even though this practice has never been studied with children younger than 4. This retrospective study analyzes the efficacy and safety of a combination of fluticasone propionate (FP) and salmeterol (SA) in children under 5. Fifty patients who started using FP/SA before the age of 60 months were included in the analysis. To determine efficacy, we tracked the change in emergency room visits, hospitalizations, and the frequency of wheezing as a result of treatment. Emergency room visits were reduced from 78 to 5 (p<0.001), hospitalizations were reduced from 43 to 2 (p<0.001) and frequency of wheezing, daily, weekly, or monthly, was also reduced significantly (p<0.003). In terms of safety, there was only a 3.4% reduction in height percentile (p=0.37). Combination therapy is highly efficacious and safe for asthmatics under the age of 5. A well-designed prospective study is necessary to further evaluate the benefits and risks of this treatment method.