BACKGROUND Despite nebulized budesonide being identified by the Global Initiative for Asthma report as a viable alternative to inhaled corticosteroids (ICS) delivered by pressurized metered-dose inhalers (pMDIs) with spacers, practical guidance on nebulized corticosteroid use in the pediatric population remains scarce. OBJECTIVE To review the current literature and provide practical recommendations for nebulized budesonide use in children aged ≤ 5 years with a diagnosis of asthma. METHODS A group of 15 expert pediatricians in the respiratory and allergy fields in Thailand developed Delphi consensus recommendations on nebulized budesonide use based on their clinical expertise and a review of the published literature. Studies that evaluated the efficacy (effectiveness) and/or safety of nebulized budesonide in children aged ≤ 5 years with asthma were assessed. AR patients. RESULTS Overall, 24 clinical studies published between 1993 and 2020 met the inclusion criteria for review. Overall, results demonstrated that nebulized budesonide significantly improved symptom control and reduced exacerbations, asthma-related hospitalizations, and the requirement for oral corticosteroids compared with placebo or active controls. Nebulized budesonide was well tolerated, with no severe or drug-related adverse events reported. Following a review of the published evidence and group consensus, a treatment algorithm as per the Thai Pediatric Asthma 2020 Guidelines was proposed, based on the availability of medications in Thailand, to include nebulized budesonide as the initial treatment option alongside ICS delivered by pMDIs with spacers in children aged ≤ 5 years. CONCLUSIONS ThNebulized budesonide is an effective and well-tolerated treatment option in children aged ≤ 5 years with asthma.

中文翻译：

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≤ 5 岁哮喘儿童家庭雾化皮质类固醇使用的实用建议：审查和咨询小组共识。

背景 尽管全球哮喘倡议报告将雾化布地奈德确定为通过带储雾器的加压计量吸入器 (pMDI) 输送的吸入皮质类固醇 (ICS) 的可行替代品，但在儿科人群中使用雾化皮质类固醇的实用指南仍然很少。目的 回顾现有文献，并为诊断为哮喘的 ≤ 5 岁儿童使用雾化布地奈德提供实用建议。方法 由泰国呼吸和过敏领域的 15 名儿科专家组成的小组根据其临床专业知识和对已发表文献的回顾，制定了关于雾化布地奈德使用的德尔菲共识建议。评估了雾化布地奈德对 ≤ 5 岁哮喘儿童的功效（有效性）和/或安全性的研究。AR患者。结果 总体而言，1993 年至 2020 年间发表的 24 项临床研究符合审查纳入标准。总体而言，结果表明，与安慰剂或活性对照相比，雾化布地奈德显着改善了症状控制，减少了病情加重、哮喘相关住院治疗以及口服皮质类固醇的需求。雾化布地奈德耐受性良好，没有报告严重或药物相关的不良事件。在对已发表的证据和小组共识进行审查后，根据泰国药物的可用性，提出了根据 2020 年泰国小儿哮喘指南的治疗算法，其中包括雾化布地奈德作为初始治疗选择，同时使用带有间隔器的 pMDI 提供的 ICS ≤ 5 岁儿童。结论 对于 ≤ 5 岁哮喘儿童，雾化布地奈德是一种有效且耐受性良好的治疗选择。