Hospital admissions of young children for status asthmaticus in Honolulu, Hawaii, 1986 to 1989.

Asthma admissions of children aged 5 years or younger to the Kaiser Foundation Hospital in Honolulu were analyzed for the years 1986-1989. Admissions increased at an annual rate of 4.5% during the study period, in agreement with a worldwide trend. Most children wheezed before their first admission, but their diagnosis was bronchitis rather than asthma. This shows that physicians find it difficult to diagnose asthma in young children. Pneumonia was the initial diagnosis in 25% of admissions, mainly due to overinterpretation of chest radiographs, and this contributed to the overuse of antibiotics. Inpatient treatment with inhaled and systemic bronchodilators and anti-inflammatory agents conformed to standard practice. Recent adoption of the guidelines by the National Asthma Education program and the establishment of an outreach program and asthma register should promote more appropriate outpatient treatment and a reduction of admissions for asthma.