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J Korean Med Assoc. 2012 Dec;55(12):1201-1206. Korean. Original Article.
Lim DH , Kim JH , Son BK .
Department of Pediatrics, Inha University School of Medicine, Incheon, Korea.
Environmental Health Center for Allergic Disease, Ministry of Environment, Gwacheon, Korea.

Daily low-dose inhaled corticosteroid in preschool children with asthma is recommended to prevent the development of asthma symptom and sign based on many asthma management guidelines. But the retarded growth after long-term steroid inhalation has been concerned. Recently the method of intermittent high-dose (suspension, 1,000 microg, 2 times a day for 7 days) budesonide inhalation when the initial phase to develop the asthma exacerbation was studied to compare the efficacy and safety with daily low-dose budesonide (500 microg) inhalation regimen in preschool children positive with modified asthma predictive index in recurrent wheezer during the study period with 52 weeks. There were no significant difference between two regimen with respect to the frequency of exacerbations, the time to the first exacerbation and to the second exacerbation, and the frequency of treatment failure. The total exposure to budesonide over the period was less in the intermittent high-dose regimen than in the daily low-dose regimen. There were no significant difference in change in height. But the change in height from baseline in intermittent high-dose regimen group was 8.01 cm and in daily low-dose was 7.76 cm. We need the more clinical studies in preschool children with persistent moderate and severe asthma and in various country and nations. It is suggested the intermittent high-dose budesonide inhalation regimen in preschool children with freqeunt wheezing may be a very good alternative to control the allergic inflammation and symptoms of asthma without concerning the adverse effect of steroid.

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