Table. Reviewing and adjusting preventer treatment for children aged 0–5 years
| Initial treatment | When to schedule review | Management options and notes | |
|---|---|---|---|
| Treatment response | No treatment response † | ||
|
Montelukast (children 2 years and over) |
2–4 weeks |
Continue montelukast treatment
|
Stop montelukast and start treatment with an inhaled corticosteroid, starting with a low dose |
|
Inhaled corticosteroid (low dose) |
4 weeks |
Continue regular treatment at low dose After ≥3 months, consider stopping treatment and reviewing in 4 weeks |
Review the diagnosis, adherence and inhaler technique Consider referral to a specialist (e.g. paediatric respiratory physician or paediatrician, if available) for assessment Consider adding montelukast (in combination with inhaled corticosteroid)‡ |
- Advise parents about potential adverse psychiatric effects of montelukast
† Symptom control not achieved with initial treatment after verifying treatment was taken as intended
‡ PBS status as at October 2016: Montelukast is not subsidised by the PBS for children aged 2–5 years with moderate-to-severe asthma, or when used in combination with another preventer.