The Thoracic Society of Australia and New Zealand, which aims to prevent respiratory illness and improve care, has released the following cautions for health care practitioners caring for children:
- Do not prescribe combination therapy (inhaled corticosteroids with long-acting beta2 agonist) as initial therapy in mild to moderate asthma before a trial of inhaled corticosteroids alone.
- Do not prescribe antibiotics for an exacerbation of asthma.
- Do not use oral beta2-agonists as bronchodilators in asthma, wheeze or bronchiolitis.
- For children with bronchiolitis without other co-morbidities, do not delay discharge from an inpatient admission based on oxygen saturations alone if saturations are ≥90%.
- Do not delay immunisation/s based on the presence of mild respiratory symptoms in the absence of fever.
The Thoracic Society of Australia and New Zealand is a member of the Royal Australian College of Physicians (RACP), and the recommendations are part of RACP’s Evolve campaign, which is similar to the Choosing Wisely campaign in New Zealand.
Royal New Zealand College of General Practitioners medical director Dr Richard Medlicott says the College has endorsed many recommendations from other specialties.
“The Thoracic Society has some very useful pointers that are of relevance to general practitioners, and I encourage GPs to have a look at them.”
More information about the recommendations, including the supporting evidence, can be found on the Choosing Wisely website.