Guidelines Summary

European Respiratory Society

Guidelines for the diagnosis of asthma in children aged 5–16 years were published in November 2021 by the European Respiratory Society (ERS) in European Respiratory Journal.^[70] Recommendations include the following:

Spirometry is recommended as part of the diagnostic workup of children aged 5–16 years with suspected asthma.
Bronchodilator reversibility (BDR) testing is recommended in all children with FEV ₁< LLN or < 80% pred and/or FEV1/FVC < LLN or < 80%.
Measurement of exhaled nitric oxide ( F _eNO) is recommended as part of the diagnostic workup of children aged 5–16 years with suspected asthma.
Diagnosing asthma in children based on clinical history alone or following a single abnormal objective test is not recommended.
PEFR variability testing as the primary objective test on its own to diagnose asthma in children aged 5–16 years is not recommended.
A direct bronchial challenge test using methacholine is recommended in children aged 5–16 years under investigation for asthma where asthma diagnosis could not be confirmed with first-line objective tests.

Medication

National Health Interview Survey, National Center for Health Statistics. CDC. Available at http://www.cdc.gov/nchs/products/pubs/pubd/hestats/ashtma03-05/asthma03-05.htm.
[Guideline] Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Summary Report 2007. J Allergy Clin Immunol. 2007 Nov. 120(5 Suppl):S94-138. [QxMD MEDLINE Link].
National Heart, Lung, and Blood Institute. Global Initiative for Asthma. National Institute for Health Publication. 1995. 95-3659.
Global strategy for asthma management and prevention. Global initiative for asthma (GINA) 2006. Available at http://ginasthma.org.
Akinbami LJ, Moorman JE, Garbe PL, Sondik EJ. Status of childhood asthma in the United States, 1980-2007. Pediatrics. 2009 Mar. 123 Suppl 3:S131-45. [QxMD MEDLINE Link].
Anderson WJ, Watson L. Asthma and the hygiene hypothesis. N Engl J Med. 2001 May 24. 344(21):1643-4. [QxMD MEDLINE Link].
Goksör E, Alm B, Thengilsdottir H, Pettersson R, Aberg N, Wennergren G. Preschool wheeze - impact of early fish introduction and neonatal antibiotics. Acta Paediatr. 2011 Dec. 100(12):1561-6. [QxMD MEDLINE Link].
Bousquet J, Jeffery PK, Busse WW, Johnson M, Vignola AM. Asthma. From bronchoconstriction to airways inflammation and remodeling. Am J Respir Crit Care Med. 2000 May. 161(5):1720-45. [QxMD MEDLINE Link].
Ege MJ, Mayer M, Normand AC, Genuneit J,et al. Exposure to environmental microorganisms and childhood asthma. N Engl J Med. 2011 Feb 24. 364(8):701-9. [QxMD MEDLINE Link].
Zucker, M. Asthma phenotype, genotype may guide future therapies. http://www.pulmonaryreviews.com [serial online]. June 2003. 8:[Full Text].
Drazen JM, Yandava CN, Dubé L, Szczerback N, Hippensteel R, Pillari A, et al. Pharmacogenetic association between ALOX5 promoter genotype and the response to anti-asthma treatment. Nat Genet. 1999 Jun. 22(2):168-70. [QxMD MEDLINE Link].
Thompson EE, Pan L, Ostrovnaya I, Weiss LA, Gern JE, Lemanske RF Jr, et al. Integrin beta 3 genotype influences asthma and allergy phenotypes in the first 6 years of life. J Allergy Clin Immunol. 2007 Jun. 119(6):1423-9. [QxMD MEDLINE Link].
Wechsler ME, Lehman E, Lazarus SC, Lemanske RF Jr, Boushey HA, Deykin A, et al. beta-Adrenergic receptor polymorphisms and response to salmeterol. Am J Respir Crit Care Med. 2006 Mar 1. 173(5):519-26. [QxMD MEDLINE Link]. [Full Text].
Moore WC, Meyers DA, Wenzel SE, Teague WG, et al. Identification of asthma phenotypes using cluster analysis in the Severe Asthma Research Program. Am J Respir Crit Care Med. 2010 Feb 15. 181(4):315-23. [QxMD MEDLINE Link]. [Full Text].
Torgerson DG, Ampleford EJ, Chiu GY, et al. Meta-analysis of genome-wide association studies of asthma in ethnically diverse North American populations. Nat Genet. 2011 Jul 31. 43(9):887-92. [QxMD MEDLINE Link].
Ferreira MA, Matheson MC, Duffy DL, et al. Identification of IL6R and chromosome 11q13.5 as risk loci for asthma. Lancet. 2011 Sep 10. 378(9795):1006-14. [QxMD MEDLINE Link].
Vinding RK, Stokholm J, Chawes BL, Bisgaard H. Blood lipid levels associate with childhood asthma, airway obstruction, bronchial hyperresponsiveness, and aeroallergen sensitization. J Allergy Clin Immunol. 2015 Jul 3. [QxMD MEDLINE Link].
Boggs W. Blood Lipid Profile Tied to Childhood Asthma and Bronchial Responsiveness. Reuters Health Information. Available at http://www.medscape.com/viewarticle/848232. July 20, 2015; Accessed: September 3, 2015.
Bisgaard H, Jensen SM, Bønnelykke K. Interaction between Asthma and Lung Function Growth in Early Life. Am J Respir Crit Care Med. 2012 Jun 1. 185(11):1183-9. [QxMD MEDLINE Link].
Lemanske RF Jr, Jackson DJ, Gangnon RE, Evans MD, Li Z, Shult PA, et al. Rhinovirus illnesses during infancy predict subsequent childhood wheezing. J Allergy Clin Immunol. 2005 Sep. 116(3):571-7. [QxMD MEDLINE Link].
Guilbert TW, Morgan WJ, Zeiger RS, Mauger DT, Boehmer SJ, Szefler SJ, et al. Long-term inhaled corticosteroids in preschool children at high risk for asthma. N Engl J Med. 2006 May 11. 354(19):1985-97. [QxMD MEDLINE Link].
Vesper S, McKinstry C, Haugland R, et al. Development of an Environmental Relative Moldiness index for US homes. J Occup Environ Med. 2007 Aug. 49(8):829-33. [QxMD MEDLINE Link].
Reponen T, Vesper S, Levin L, et al. High environmental relative moldiness index during infancy as a predictor of asthma at 7 years of age. Ann Allergy Asthma Immunol. 2011 Aug. 107(2):120-6. [QxMD MEDLINE Link].
Farah CS, Kermode JA, Downie SR, et al. Obesity is a determinant of asthma control independent of inflammation and lung mechanics. Chest. 2011 Sep. 140(3):659-66. [QxMD MEDLINE Link].
Quinto KB, Zuraw BL, Poon KY, Chen W, Schatz M, Christiansen SC. The association of obesity and asthma severity and control in children. J Allergy Clin Immunol. 2011 Nov. 128(5):964-9. [QxMD MEDLINE Link].
Goleva E, Searing DA, Jackson LP, Richers BN, Leung DY. Steroid requirements and immune associations with vitamin D are stronger in children than adults with asthma. J Allergy Clin Immunol. 2012 May. 129 (5):1243-51. [QxMD MEDLINE Link].
Mitchell EA, Beasley R, Keil U, Montefort S, Odhiambo J, ISAAC Phase Three Study Group. The association between tobacco and the risk of asthma, rhinoconjunctivitis and eczema in children and adolescents: analyses from Phase Three of the ISAAC programme. Thorax. 2012 Nov. 67 (11):941-9. [QxMD MEDLINE Link].
Sheehan WJ, Mauger DT, Paul IM, et al. Acetaminophen versus Ibuprofen in Young Children with Mild Persistent Asthma. N Engl J Med. 2016 Aug 18. 375 (7):619-30. [QxMD MEDLINE Link].
Barclay L. Acetaminophen vs Ibuprofen Does Not Worsen Childhood Asthma. Medscape Medical News. Available at http://www.medscape.com/viewarticle/867592. August 17, 2016; Accessed: August 19, 2016.
Mathilda Chiu YH, Coull BA, Cohen S, Wooley A, Wright RJ. Prenatal and postnatal maternal stress and wheeze in urban children: effect of maternal sensitization. Am J Respir Crit Care Med. 2012 Jul 15. 186(2):147-54. [QxMD MEDLINE Link]. [Full Text].
Harpsøe MC, Basit S, Bager P, Wohlfahrt J, Benn CS, Nøhr EA, et al. Maternal obesity, gestational weight gain, and risk of asthma and atopic disease in offspring: A study within the Danish National Birth Cohort. J Allergy Clin Immunol. 2012 Nov 1. [QxMD MEDLINE Link].
Donohue KM, Miller RL, Perzanowski MS, Just AC, Hoepner LA, Arunajadai S, et al. Prenatal and postnatal bisphenol A exposure and asthma development among inner-city children. J Allergy Clin Immunol. 2013 Mar. 131(3):736-742.e6. [QxMD MEDLINE Link].
Barclay L. BPA Exposure Linked to Childhood Asthma Risk. Available at http://www.medscape.com/viewarticle/780110. Accessed: March 12, 2013.
Asthma prevalence and control characteristics by race/ethnicity--United States, 2002. MMWR Morb Mortal Wkly Rep. 2004 Feb 27. 53(7):145-8. [QxMD MEDLINE Link].
Moorman JE, Rudd RA, Johnson CA, King M, Minor P, Bailey C, et al. National surveillance for asthma--United States, 1980-2004. MMWR Surveill Summ. 2007 Oct 19. 56(8):1-54. [QxMD MEDLINE Link].
Arshad SH, Karmaus W, Raza A, Kurukulaaratchy RJ, Matthews SM, Holloway JW, et al. The effect of parental allergy on childhood allergic diseases depends on the sex of the child. J Allergy Clin Immunol. 2012 May 17. [QxMD MEDLINE Link].
Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med. 1995 Jan 19. 332(3):133-8. [QxMD MEDLINE Link].
Castro-Rodríguez JA, Holberg CJ, Wright AL, Martinez FD. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med. 2000 Oct. 162(4 Pt 1):1403-6. [QxMD MEDLINE Link].
Osterwell N. 50 Years On: Severe Childhood Asthma Persists in Middle Age. Medscape Medical News. Available at http://www.medscape.com/viewarticle/826597. Accessed: June 16, 2014.
Tai A, Tran H, Roberts M, Clarke N, Gibson AM, Vidmar S, et al. Outcomes of childhood asthma to the age of 50 years. J Allergy Clin Immunol. 2014 Jun. 133(6):1572-1578.e3. [QxMD MEDLINE Link].
Coffman JM, Cabana MD, Yelin EH. Do school-based asthma education programs improve self-management and health outcomes?. Pediatrics. 2009 Aug. 124(2):729-42. [QxMD MEDLINE Link]. [Full Text].
Wu AC, Tantisira K, Li L, Schuemann B, Weiss ST, Fuhlbrigge AL. Predictors of Symptoms are Different from Predictors of Severe Exacerbations from Asthma in Children. Chest. 2011 Feb 3. [QxMD MEDLINE Link].
Crapo RO, Casaburi R, Coates AL, Enright PL, Hankinson JL, Irvin CG. Guidelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med. 2000 Jan. 161(1):309-29. [QxMD MEDLINE Link].
Stern G, de Jongste J, van der Valk R, Baraldi E, Carraro S, Thamrin C, et al. Fluctuation phenotyping based on daily fraction of exhaled nitric oxide values in asthmatic children. J Allergy Clin Immunol. 2011 Aug. 128(2):293-300. [QxMD MEDLINE Link].
Robroeks CM, van Vliet D, Jöbsis Q, Braekers R, Rijkers GT, Wodzig WK, et al. Prediction of asthma exacerbations in children: results of a one-year prospective study. Clin Exp Allergy. 2012 May. 42(5):792-8. [QxMD MEDLINE Link].
Wu AC, Tantisira K, Li L, Fuhlbrigge AL, Weiss ST, Litonjua A. Effect of vitamin D and inhaled corticosteroid treatment on lung function in children. Am J Respir Crit Care Med. 2012 Sep 15. 186(6):508-13. [QxMD MEDLINE Link]. [Full Text].
Holbrook JT, Wise RA, Gold BD, et al. Lansoprazole for children with poorly controlled asthma: a randomized controlled trial. JAMA. 2012 Jan 25. 307(4):373-81. [QxMD MEDLINE Link].
Brozek JL, Kraft M, Krishnan JA, Cloutier MM, Lazarus SC, Li JT, et al. Long-Acting ß2-Agonist Step-off in Patients With Controlled Asthma: Systematic Review With Meta-analysis. Arch Intern Med. 2012 Aug 27. 1-11. [QxMD MEDLINE Link].
Nelson HS, Weiss ST, Bleecker ER, Yancey SW, Dorinsky PM. The Salmeterol Multicenter Asthma Research Trial: a comparison of usual pharmacotherapy for asthma or usual pharmacotherapy plus salmeterol. Chest. 2006 Jan. 129(1):15-26. [QxMD MEDLINE Link].
Salpeter SR, Wall AJ, Buckley NS. Long-acting beta-agonists with and without inhaled corticosteroids and catastrophic asthma events. Am J Med. 2010 Apr. 123(4):322-8.e2. [QxMD MEDLINE Link].
US Food and Drug Administration. FDA Drug Safety Communication: New safety requirements for long-acting inhaled asthma medications called Long-Acting Beta-Agonists (LABA). Human Department of Health and Human services. Feb 18, 2010. 1-4. [Full Text].
Lemanske RF, Mauger DT, Sorkness CA, et al. Step-up therapy for children with uncontrolled asthma receiving inhaled corticosteroids. N Engl J Med. March 30, 2010. 362:975-85.
Pearlman DS, et al. Efficacy of budesonide/formoterol pressurized metered-dose inhaler versus budesonide alone in children (6-. Presented at the American College of Allergy, Asthma & Immunology 2016 Annual Scientific Meeting. San Francisco, CA</i>. 2016 Nov 13.
Rachelefsky G. Inhaled corticosteroids and asthma control in children: assessing impairment and risk. Pediatrics. 2009 Jan. 123(1):353-66. [QxMD MEDLINE Link].
Martinez FD, Chinchilli VM, Morgan WJ, Boehmer SJ, Lemanske RF Jr, Mauger DT, et al. Use of beclomethasone dipropionate as rescue treatment for children with mild persistent asthma (TREXA): a randomised, double-blind, placebo-controlled trial. Lancet. 2011 Feb 19. 377(9766):650-7. [QxMD MEDLINE Link].
Farber HJ, Silveira EA, Vicere DR, Kothari VD, Giardino AP. Oral Corticosteroid Prescribing for Children With Asthma in a Medicaid Managed Care Program. Pediatrics. 2017 May. 139 (5):e20164146. [QxMD MEDLINE Link].
Kuehn BM. Asthma: Overuse of Oral Steroids Suggests Underuse of Inhalers. Medscape Medical News. Available at http://www.medscape.com/viewarticle/878503. April 12, 2017; Accessed: April 12, 2017.
Quon BS, Fitzgerald JM, Lemière C, Shahidi N, Ducharme FM. Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children. Cochrane Database Syst Rev. 2010 Dec 8. CD007524. [QxMD MEDLINE Link].
Agertoft L, Pedersen S. Effect of long-term treatment with inhaled budesonide on adult height in children with asthma. N Engl J Med. 2000 Oct 12. 343(15):1064-9. [QxMD MEDLINE Link].
Long-term effects of budesonide or nedocromil in children with asthma. The Childhood Asthma Management Program Research Group. N Engl J Med. 2000 Oct 12. 343(15):1054-63. [QxMD MEDLINE Link].
Rodrigo GJ, Neffen H, Castro-Rodriguez JA. Efficacy and safety of subcutaneous omalizumab vs placebo as add-on therapy to corticosteroids for children and adults with asthma: a systematic review. Chest. 2011 Jan. 139(1):28-35. [QxMD MEDLINE Link].
Busse WW, Morgan WJ, Gergen PJ, Mitchell HE, Gern JE, Liu AH, et al. Randomized trial of omalizumab (anti-IgE) for asthma in inner-city children. N Engl J Med. 2011 Mar 17. 364(11):1005-15. [QxMD MEDLINE Link].
Omalizumab May Help Kids With Uncontrolled Allergic Asthma. Medscape. Apr 4 2013. [Full Text].
Deschildre A, Marguet C, Salleron J, et al. Add-on omalizumab in children with severe allergic asthma: a one year real life survey. Eur Respir J. 2013 Mar 21. [QxMD MEDLINE Link].
Cates CJ, Bestall J, Adams N. Holding chambers versus nebulisers for inhaled steroids in chronic asthma. Cochrane Database Syst Rev. 2006 Jan 25. CD001491. [QxMD MEDLINE Link].
Vuillermin PJ, Robertson CF, Carlin JB, Brennan SL, Biscan MI, South M. Parent initiated prednisolone for acute asthma in children of school age: randomised controlled crossover trial. BMJ. 2010 Mar 1. 340:c843. [QxMD MEDLINE Link]. [Full Text].
Halterman JS, Szilagyi PG, Fisher SG, Fagnano M, Tremblay P, Conn KM, et al. Randomized controlled trial to improve care for urban children with asthma: results of the school-based asthma therapy trial. Arch Pediatr Adolesc Med. 2011 Mar. 165(3):262-8. [QxMD MEDLINE Link].
Bhattacharjee R, Choi BH, Gozal D, Mokhlesi B. Association of adenotonsillectomy with asthma outcomes in children: a longitudinal database analysis. PLoS Med. 2014 Nov. 11(11):e1001753. [QxMD MEDLINE Link]. [Full Text].
Harding A. Adenotonsillectomy for OSA improves asthma in kids. Reuters Health Information. November 06, 2014. [Full Text].
[Guideline] Gaillard EA, Kuehni CE, Turner S, et al. European Respiratory Society clinical practice guidelines for the diagnosis of asthma in children aged 5-16 years. Eur Respir J. 2021 Oct. 58 (5):[QxMD MEDLINE Link]. [Full Text].
ProAir Digihaler (albuterol) [package insert]. Frazer, PA: Teva Respiratory, LLC. 12/2018. Available at [Full Text].
Postma DS, O'Byrne PM, Pedersen S. Comparison of the effect of low-dose ciclesonide and fixed-dose fluticasone propionate and salmeterol combination on long-term asthma control. Chest. 2011 Feb. 139(2):311-8. [QxMD MEDLINE Link].
Pavord ID, Korn S, Howarth P, Bleecker ER, Buhl R, Keene ON, et al. Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebo-controlled trial. Lancet. 2012 Aug 18. 380 (9842):651-9. [QxMD MEDLINE Link].
Ortega HG, Liu MC, Pavord ID, Brusselle GG, FitzGerald JM, Chetta A, et al. Mepolizumab treatment in patients with severe eosinophilic asthma. N Engl J Med. 2014 Sep 25. 371 (13):1198-207. [QxMD MEDLINE Link]. [Full Text].
Bel EH, Wenzel SE, Thompson PJ, Prazma CM, Keene ON, Yancey SW, et al. Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma. N Engl J Med. 2014 Sep 25. 371 (13):1189-97. [QxMD MEDLINE Link]. [Full Text].
Bleecker ER, FitzGerald JM, Chanez P, Papi A, Weinstein SF, Barker P, et al. Efficacy and safety of benralizumab for patients with severe asthma uncontrolled with high-dosage inhaled corticosteroids and long-acting β₂-agonists (SIROCCO): a randomised, multicentre, placebo-controlled phase 3 trial. Lancet. 2016 Oct 29. 388 (10056):2115-2127. [QxMD MEDLINE Link].
FitzGerald JM, Bleecker ER, Nair P, Korn S, Ohta K, Lommatzsch M, et al. Benralizumab, an anti-interleukin-5 receptor α monoclonal antibody, as add-on treatment for patients with severe, uncontrolled, eosinophilic asthma (CALIMA): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2016 Oct 29. 388 (10056):2128-2141. [QxMD MEDLINE Link].
Nair P, Wenzel S, Rabe KF, Bourdin A, Lugogo NL, Kuna P, et al. Oral Glucocorticoid-Sparing Effect of Benralizumab in Severe Asthma. N Engl J Med. 2017 Jun 22. 376 (25):2448-2458. [QxMD MEDLINE Link].
Castro M, Corren J, Pavord ID, Maspero J, Wenzel S, Rabe KF, et al. Dupilumab Efficacy and Safety in Moderate-to-Severe Uncontrolled Asthma. N Engl J Med. 2018 Jun 28. 378 (26):2486-2496. [QxMD MEDLINE Link].
Rabe KF, Nair P, Brusselle G, Maspero JF, Castro M, Sher L, et al. Efficacy and Safety of Dupilumab in Glucocorticoid-Dependent Severe Asthma. N Engl J Med. 2018 Jun 28. 378 (26):2475-2485. [QxMD MEDLINE Link].
Menzies-Gow A, Corren J, Bourdin A, et al. Tezepelumab in adults and adolescents with severe, uncontrolled asthma. N Engl J Med. 2021 May 13. 384 (19):1800-9. [QxMD MEDLINE Link]. [Full Text].

Media Gallery

of 0

Table 1. Stepwise Approach to Asthma Medications

Table 1. Stepwise Approach to Asthma Medications

Intermittent Asthma		Persistent Asthma: Daily Medication
Age	Step 1	Step 2	Step 3	Step 4	Step 5	Step 6
< 5 y	Rapid-acting beta2-agonist prn	Low-dose inhaled corticosteroid (ICS)	Medium-dose ICS	Medium-dose ICS plus either long-acting beta2-agonist (LABA) or montelukast	High-dose ICS plus either LABA or montelukast	High-dose ICS plus either LABA or montelukast; Oral systemic corticosteroid
		Alternate regimen: cromolyn or montelukast
5-11 y	Rapid-acting beta2-agonist prn	Low-dose ICS	Either low-dose ICS plus either LABA, LTRA, or theophylline OR Medium-dose	Medium-dose ICS plus LABA	High-dose ICS plus LABA	High-dose ICS plus LABA plus oral systemic corticosteroid
		Alternate regimen: cromolyn, leukotriene receptor antagonist (LTRA), or theophylline		Alternate regimen: medium-dose ICS plus either LTRA or theophylline	Alternate regimen: high-dose ICS plus either LABA or theophylline	Alternate regimen: high-dose ICS plus LRTA or theophylline plus systemic corticosteroid
12 y or older	Rapid-acting beta2-agonist as needed	Low-dose ICS	Low-dose ICS plus LABA OR Medium-dose ICS	Medium-dose ICS plus LABA	High-dose ICS plus LABA (and consider omalizumab for patients with allergies)	High-dose ICS plus either LABA plus oral corticosteroid (and consider omalizumab for patients with allergies)
		Alternate regimen: cromolyn, LTRA, or theophylline	Alternate regimen: low-dose ICS plus either LTRA, theophylline, or zileuton	Alternate regimen: medium-dose ICS plus either LTRA, theophylline, or zileuton

Back to List

Author

Girish D Sharma, MD, FCCP, FAAP Professor of Pediatrics, Rush Medical College; Director, Section of Pediatric Pulmonology and Rush Cystic Fibrosis Center, Rush Children's Hospital, Rush University Medical Center

Girish D Sharma, MD, FCCP, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, Royal College of Physicians of Ireland

Disclosure: Nothing to disclose.

Coauthor(s)

Payel Gupta, MD Department of Allergy and Immunology, ENT Faculty Practice

Payel Gupta, MD is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Charles Callahan, DO Professor, Chief, Department of Pediatrics and Pediatric Pulmonology, Tripler Army Medical Center

Charles Callahan, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American College of Osteopathic Pediatricians, American Thoracic Society, The Society of Federal Health Professionals (AMSUS), Christian Medical and Dental Associations

Disclosure: Nothing to disclose.

Chief Editor

Kenan Haver, MD Associate Professor of Pediatrics, Harvard Medical School; Director of Asthma Program, Director of Flexible Bronchoscopy Program, Director of Pulmonary Division Asthma Program, Co-Director of Primary Ciliary Dyskinesia, Co-Leader of Empyema Standardized Clinical Assessment and Management Plans (SCAMP), Boston Children’s Hospital

Kenan Haver, MD is a member of the following medical societies: American Academy of Pediatrics, American Thoracic Society

Disclosure: Author for: UptoDate.

Additional Contributors

Thomas Scanlin, MD Chief, Division of Pulmonary Medicine and Cystic Fibrosis Center, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School

Thomas Scanlin, MD is a member of the following medical societies: American Association for the Advancement of Science, Society for Pediatric Research, American Society for Biochemistry and Molecular Biology, American Thoracic Society, Society for Pediatric Research

Disclosure: Nothing to disclose.