Prophylactic salbutamol use for pediatric exercise-induced bronchoconstriction.

QUESTION: An 8-year-old child was seen in our clinic for shortness of breath and wheezing after running at school. He was clinically healthy with no other symptoms consistent with asthma. His parents read that in adults, salbutamol could be taken before exercise to prevent shortness of breath and wheezing, but were unsure whether this also applied to children. Is salbutamol safe and effective for preventing exercise-induced bronchoconstriction (EIB) in pediatric patients?

ANSWER: Effective management of EIB in children supports greater participation in physical activity, which is important for physical and emotional well-being. Pediatric studies found salbutamol is safe and effective for preventing EIB in children when administered 15 to 30 minutes before exercise. Children can develop a tolerance to salbutamol if used frequently; therefore, salbutamol should be used less than once per day to maintain effectiveness. If children require salbutamol more often, additional therapies to manage airway inflammation can be considered.