Guideline

WHO consolidated guidelines for the management of common childhood illness: management of asthma in children and adolescents and bronchiolitis in infants and young children

Year of Publication

2026

Issuing Institution

World Health Organization

Links

Recommendations

10 included recommendations

Nebulized ipratropium bromide should be added to standard first-line therapy with inhaled short-acting beta2 agonist (SABA) and systemic corticosteroids for severe paediatric asthma exacerbations in health facilities.

Status

New

Recommended in favor

Strong

Certainty of evidence

Low

Nebulized ipratropium bromide should be added for moderate paediatric asthma exacerbations not responsive to initial standard first-line therapy with inhaled short-acting beta2 agonist (SABA) and systemic corticosteroids in health facilities.

Status

Updated

Recommended in favor

Strong

Certainty of evidence

Low

Intravenous (IV) magnesium sulfate (as a single short infusion) should be used as second-line therapy for severe paediatric asthma exacerbations, and for moderate exacerbations not responsive to standard first-line therapy with inhaled/nebulized medicines (short-acting beta2 agonist (SABA) and ipratropium) and systemic corticosteroids in health care facilities.

Status

Updated

Recommended in favor

Strong

Certainty of evidence

Low

Intravenous (IV) aminophylline should not be used as second-line therapy for severe paediatric asthma exacerbations in health care facilities if alternative second-line options are available.

Status

Updated

Recommended against

Conditional

Certainty of evidence

Low

Intravenous (IV) short-acting beta2 agonist (SABA) should be used as a potential second-line therapy for severe paediatric asthma exacerbations in addition to standard first-line therapy with inhaled/nebulized medicines (SABA and ipratropium) and systemic corticosteroids in health care facilities.

Status

Updated

Recommended in favor

Strong

Certainty of evidence

High

Intravenous (IV) magnesium sulfate should be the preferred option for second-line therapy and IV short-acting beta2 agonist (SABA) the preferred option for third-line therapy in severe paediatric asthma exacerbations not responding to standard first-line therapy.

Status

Updated

Recommended in favor

Conditional

Certainty of evidence

Very low

Combination inhaler (steroid plus fast-onset long-acting beta2 agonist) maintenance and reliever therapy (MART) should be considered for children with persistent asthma symptoms requiring regular inhaled corticosteroids (ICS) treatment.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Moderate

In infants and children aged less than 2 years presenting or hospitalized with suspected bronchiolitis, routine use of chest X-ray is not suggested for the initial diagnosis and management of bronchiolitis.

Status

New

Recommended against

Conditional

Certainty of evidence

Very low

In infants and children aged less than 2 years, hospitalized with acute bronchiolitis with hypoxaemia, humidified high-flow nasal cannula (HHFNC) oxygen is suggested rather than standard flow oxygen (SFO).

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

In infants and children aged less than 2 years presenting or hospitalized with bronchiolitis, a trial of nebulized hypertonic saline (3%) is suggested rather than no nebulization.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low