Factors that affect the efficacy of inhaled corticosteroids for infants and young children

Israel Amirav, Michael T. Newhouse, Stefan Minocchieri, Jose A. Castro-Rodriguez, Karen G. Schüepp

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Infants (0-1 years of age) and young children (1-3 years of age) are a unique subpopulation with regard to inhaled therapies. There are various anatomic, physiological, and emotional factors peculiar to this age group that present significant difficulties and challenges for aerosol delivery. Most studies of therapeutic aerosols that have been performed with patients of this age group, particularly recent studies with inhaled corticosteroids (ICSs), administered aerosols with relatively large particles (ie, >3 μm in mass median aerodynamic diameter). These drugs were designed for use in adults and older children and were administered with masks, which are frequently rejected by patients. Based on these studies, it was recently suggested that ICSs might not be as therapeutically effective in infants and young children as in adults. We review the reasons that large-particle corticosteroid aerosols are not likely to be effective in infants and young children. This patient population differs from adults in airway anatomy and physiology, as well as in behavior and adherence to therapy. We suggest that the benefit of ICSs in this age group requires further evaluation to determine whether better therapeutic outcomes might be achieved with smaller particles.

Original languageEnglish
Pages (from-to)1206-1211
Number of pages6
JournalJournal of Allergy and Clinical Immunology
Issue number6
StatePublished - Jun 2010
Externally publishedYes


Disclosure of potential conflict of interest: M. T. Newhouse is a shareholder of Pfizer. S. Minocchieri and K. G. Schüepp have received research support from the Swiss National Science Foundation . The rest of the authors have declared that they have no conflict of interest. S. Minocchieri has been supported by a personal grant ( PBZHP3-123293 ) from Swiss National Science Research Foundation .

FundersFunder number
Swiss National Science Research Foundation
Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung


    • Small-particle aerosols
    • adherence
    • aerosol delivery devices
    • asthma
    • corticosteroids
    • infants
    • inhalers
    • nebulizers


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