Nebulised steroids are a very effective form of treatment. A very small dose of steroids is inhaled from a nebuliser in the form of a fine spray of minute droplets which allows the drug to be spread over a wide area of the lungs and rapidly absorbed. Nebulisers can be used from one month old upwards, e.g. in wheezy infants and toddlers. Very ill children too breathless to use other types of inhaler often benefit from a nebulised therapy. Nebulisers often improve compliance, particularly with toddlers. In many children, nebulised therapy maintains lung function as effectively as oral prednisolone, while minimising the risk of systemic side-effects and improving the patient's quality of life. Experienced primary health-care teams can start a child on nebulised therapy in the community, but it should ideally be initiated in conjunction with a local paediatrician skilled in asthma management. Well managed nebuliser therapy can help prevent hospital admissions.
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