Asthma in children.

Despite advances in the understanding of asthma, there is still a high rate of morbidity and mortality from this disease in children. Although many factors are involved, a persistent concern is that the overuse of beta-agonists combined with the underuse of antiinflammatory medications leads to increased mortality. The demonstration that airway inflammation is present in mild asthma and the observations that inflammatory stimuli increase airway responsiveness have led to the use of antiinflammatory agents at earlier stages of disease. However, the medications with antiinflammatory activity that are currently available are not effective for all patients. The problems posed by chronic severe asthma in a child despite appropriate use of corticosteroids suggest that our current concepts are overly simplistic. Therefore, health care workers dealing with this disease must maintain an open mind about what constitutes optimal therapy.