BRONCHIAL ASTHMA IN CHILDREN: MODERN PHARMACOTHERAPY AND CRITERIA FOR DRUG SELECTION
Keywords:
pediatric asthma, bronchial asthma, inhaled corticosteroids, β2-agonists, leukotriene receptor antagonists, monoclonal antibodies, pharmacotherapy, drug selection criteria, airway inflammation, asthma management, evidence-based therapy, patient-centered care.Abstract
Bronchial asthma in children represents a prevalent chronic inflammatory airway disorder characterized by variable airflow obstruction, airway hyperresponsiveness, and recurrent episodes of wheezing, coughing, and dyspnea. Over the past decades, significant advancements have been made in understanding the pathophysiology, immunological mechanisms, and environmental triggers associated with pediatric asthma. Despite this progress, optimal pharmacotherapy and rational drug selection remain challenging due to age-specific considerations, variable disease phenotypes, and the potential adverse effects of long-term medication. Modern therapeutic strategies emphasize a stepwise approach based on disease severity, frequency of exacerbations, and individual patient response. Inhaled corticosteroids remain the cornerstone of long-term control therapy, effectively reducing airway inflammation and minimizing exacerbation risk, while bronchodilators such as short-acting and long-acting β2-agonists provide rapid symptomatic relief and maintenance therapy, respectively. Adjunctive medications, including leukotriene receptor antagonists and monoclonal antibodies targeting IgE or interleukins, are increasingly utilized for specific phenotypes or severe, refractory cases. The choice of pharmacological agents must consider patient age, inhalation technique, adherence potential, comorbidities, and safety profiles, alongside the minimization of systemic side effects. Additionally, non-pharmacological interventions—including trigger avoidance, environmental modification, vaccination, and patient/caregiver education—play a critical role in overall disease management. Contemporary pediatric asthma care requires individualized treatment plans, regular monitoring of lung function and symptom control, and adherence to evidence-based guidelines to achieve optimal outcomes. This review synthesizes current knowledge on pharmacotherapeutic options for children with bronchial asthma and provides practical criteria for rational drug selection in daily clinical practice, thereby supporting both efficacy and safety of treatment.
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