The ADMIT series--issues in inhalation therapy. 5) Inhaler selection in children with asthma

Prim Care Respir J. 2010 Sep;19(3):209-16. doi: 10.4104/pcrj.2010.00043.


Many children with asthma do not use their inhalers correctly and consequently gain little or no therapeutic benefit from the treatment. The focus of inhalation therapy should be on those inhalers which are easiest to use correctly by various groups of children and the amount of tuition and training required to obtain a correct technique. It is recommended that clinicians focus on a limited number of inhalers. Most children can be taught effective inhalation therapy by using a pMDI, a pMDI with a spacer ,or a DPI. Most preschool children can be taught effective use of a pMDI and spacer with a valve system and a face mask. Therefore, this is the preferred mode of delivery in these age groups. When the child is capable of using the spacer without a face mask this administration technique should be adopted. In older children pMDIs are more difficult to use correctly than a pMDI with a spacer, a DPI ,or a breath-actuated pMDI. Because DPIs and breath-actuated pMDIs are more convenient to use these devices are normally considered the preferred inhalation devices in these age groups except for administration of beclometasone dipropionate, which for safety reasons should be delivered by a spacer.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Age Factors
  • Anti-Asthmatic Agents / administration & dosage*
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / drug therapy*
  • Child
  • Child, Preschool
  • Dry Powder Inhalers
  • Humans
  • Infant
  • Inhalation Spacers
  • Metered Dose Inhalers
  • Nebulizers and Vaporizers*
  • Patient Education as Topic


  • Anti-Asthmatic Agents