Choosing Wisely:

Don’t use long-acting beta-agonist (LABA)/steroid combination drugs as initial therapy for intermittent or mild persistent asthma.

Rationale and Comments: LABA medications provide sustained bronchodilation over a 12- to 24-hour period after delivery. For the treatment of asthma, they are supplied in combination with an inhaled steroid medication via a metered dose inhaler or dry powder inhaler. Children with intermittent asthma have only occasional need for bronchodilators and do not benefit from the use of LABAs on a daily basis. Children with mild persistent asthma are usually well-controlled with a single agent – either a leukotriene modifier or a low-dose inhaled corticosteroid medication. The addition of a LABA is not recommended in these circumstances and should be reserved for children with moderate persistent or severe persistent asthma.
Sponsoring Organizations:
  • N/A
  • Sources:
  • National Asthma Education and Prevention Program guideline
  • Global Initiative for Asthma guidelines
  • Disciplines:
  • Pulmonary medicine
  • References: • National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Bethesda, MD: National Heart, Lung, and Blood Institute; 2007.
    • Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2016.

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