Table 6.

Asthma treatment in children older than 6 years according to the GINA guideline [1].

Step 1	Step 2	Step 3	Step 4	Step 5
Asthma education. Environmental control
(If step-up treatment is being considered for poor symptom, first check inhaler technique, check adherence, and confirm that symptoms are due to asthma.)
As needed rapid-acting β 2 agonist
	Select   one	Select   one	To   step   3   treatment  Select   one   or   more	To   step   4   treatment  add   either
Controller options	Low dose ICS	Low dose ICS+ long-acting  β 2   agonist	Medium- or high-dose ICS+ long-acting β 2   agonist	Oral glucocorticosteroid (lowest dose)
		Medium- or high-dose ICS  Low-dose ICS + leukotriene modifier	leukotriene modifier  sustained release theophylline	Anti-IgE treatment
		Low-dose ICS + sustained release theophylline

ICS: inhaled corticosteroids. Italic and Bold words refer to the recommended treatment. Alternative reliever treatments include inhaled anticholinergics, short-acting oral β ₂ agonist, some long-acting β ₂ agonist, and short-acting theophiline. Regular using of short- and long-acting β ₂ agonist is not advised unless accompanied by ICS.