Table 75-12.

Preferred Treatment of Asthma According to Severity

Severity	Preferred Treatment	Alternative Treatments	Comments
Intermittent	No daily medication needed		Severe exacerbations may occur, separated by long periods of no symptoms. Treat with a course of systemic corticosteroids
Mild persistent	Low-dose inhaled corticosteroid	Cromolyn Leukotriene modifier Nedocromil Sustained-release theophylline (level, 5-15 μg/mL)
Moderate persistent	Low- to medium-dose inhaled corticosteroid and long-acting inhaled ß2-agonist	Increased inhaled corticosteroid within medium-dose range or low- to medium-dose inhaled corticosteroid and either a leukotriene modifier or theophylline	If exacerbations occur despite daily medication, increase the inhaled corticosteroid and add a long-acting inhaled ß2-agonist
Severe persistent	High-dose inhaled corticosteroids and long-acting inhaled ß2-agonists

Adapted from Bacharier LB, Strunk RC: Asthma in older children. In Leung DYM, Sampson HA, Gehr RS, Szefler SJ (eds): Pediatric Allergy: Principles and Practice. Philadelphia, CV Mosby, 2003, p 416.