Guidance on the use of inhaler systems (devices) in children under the age of 5 years with chronic asthma

For children under the age of 5 years with chronic stable asthma both corticosteroids and bronchodilator therapy should be routinely delivered by pressurised metered dose inhaler (pMDI) and spacer system, with a facemask where necessary.

Where this combination is not clinically effective for the child and depending on the child's condition, nebulised therapy may be considered and in the case of children aged 3 to 5 years, a dry powder inhaler (DPI) may also be considered.

Choice of device to be made within the pMDI and spacer range should be primarily governed by specific individual need and the likelihood of good compliance. Once these factors have been taken into account, choice should be made on the basis of cost minimisation.