BRONCHIAL ASTHMA: CONTROL PROTOCOLS AND USE OF INHALED CORTICOSTEROIDS IN PEDIATRICS

Abstract

Introduction: Bronchial asthma is a chronic inflammatory disease of the airways, characterized by hyperresponsiveness and variable airflow obstruction. Although most children present with mild or moderate forms, some maintain inadequate control, reinforcing the importance of critically evaluating therapeutic protocols and the use of inhaled corticosteroids in the pediatric population. Methodology: This is a narrative literature review, with data collected from a search using the descriptors "Bronchial asthma", "Child", "Treatment", and "Diagnosis" in the PubMed database. Articles from the last five years were selected, with full text available in Portuguese, English, or Spanish. Duplicate studies, research that did not address pediatrics, reviews without clear methodological criteria, and articles not indexed in the aforementioned database were excluded. Results: The management of pediatric asthma is guided by the Asthma Control Test (ACT), which directs progressive therapeutic adjustments according to the level of control. Inhaled corticosteroids are the mainstay of treatment, indicated from mild stages, in combination with long-acting bronchodilators when necessary. In severe, uncontrolled cases, biological therapies have demonstrated a significant reduction in exacerbations and improvement in pulmonary function. Non-pharmacological strategies, including health education and pulmonary rehabilitation, have proven complementary to pharmacological treatment, contributing to better clinical control. Conclusion: Bronchial asthma in children has a significant impact on morbidity, quality of life, and healthcare costs. Inhaled corticosteroids were considered the first-line anti-inflammatory therapy in maintenance treatment. However, vigilance regarding their adverse effects is necessary, aligned with the systematic implementation of care protocols based on national and international guidelines, educational interventions, and the work of a multidisciplinary team for successful treatment and adherence.