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Arch Dis Child 82:185-187 doi:10.1136/adc.82.3.185
  • Leading article

How to choose delivery devices for asthma

Table 1

Age specific recommendations for drug delivery devices

Age (years) First choice Second choice Comments
0–2 MDI + spacer and facemask Nebuliser Ensure optimum spacer use
Avoid “open vent” nebulisers
3–6 MDI + spacer Nebuliser Very few children at this age can use dry powder inhalers adequately
6–12 (bronchodilators) MDI + spacer, breath actuated  or dry powder inhaler If using breath actuated or dry powder inhaler, also prescribe MDI  + spacer for acute exacerbations
6–12 (steroids) MDI + spacer Dry powder inhaler May need to adjust dose if switching between inhalers
Advise mouth rinsing or gargling
12+ (bronchodilators) Dry powder inhaler or breath  actuated MDI
12+ (steroids) MDI + spacer Dry powder inhaler or breath  actuated MDI May need to adjust dose if switching between inhalers
Advise mouth rinsing or gargling
Acute asthma (all ages) MDI + spacer Nebuliser Ensure optimum spacer use and appropriate dosing
Nebulise for a set period of time
Written instructions for what to do in acute asthma
  • MDI, pressurised metered dose inhaler.

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