Bibliographic information
GuidelineWHO 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 Publication2026
Issuing InstitutionWorld Health Organization
Recommendation
Updated
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.
Recommended in favor
Strong
Certainty of evidence
High
Notes and Remarks
IV SABA can be used as a potential second-line therapy, depending on the availability of other options. IV magnesium sulfate would be preferred as second-line therapy, if available (see Recommendation 5).
- IV SABA is most likely to be used in the PICU or settings where the infrastructure and monitoring already exist.
- Careful clinical monitoring is recommended to ensure the early identification and management of possible cardiovascular adverse effects, such as tachycardia, hypotension and arrhythmias.
- Where resources are available, it is advisable to have continuous ECG monitoring, and check serum electrolytes (hypokalaemia) and lactate.