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

Overview

Respiratory illnesses are a leading global cause of morbidity, health care utilization and preventable death in children. Asthma and bronchiolitis are among the most common causes of respiratory distress and wheeze, particularly in low- and middle-income countries (LMICs). The WHO consolidated guidelines for the management of common childhood illness: management of asthma in children and adolescents and bronchiolitis in infants and young children provides updated global normative guidance on asthma and bronchiolitis.

This guideline provides evidence-based recommendations on asthma in children and adolescents (0–19 years), alongside recommendations for bronchiolitis in infants and young children. It supports Member States in strengthening quality of care for paediatric respiratory conditions and advancing universal health coverage and Sustainable Development Goal targets on noncommunicable diseases (SDG 3.4) and child survival (SDG 3.2). Developed using WHO standard methods and the GRADE approach, the guideline provides recommendations across priority clinical areas:

Asthma (children and adolescents):

• Acute management of asthma exacerbations, including use of inhaled bronchodilators and systemic corticosteroids.
• Second-line therapies for severe exacerbations, including intravenous magnesium sulfate and other escalation options.
• Rational use of medicines, including avoidance of less effective or higher-risk treatments where alternatives exist.
• Long-term management strategies, including inhaled corticosteroids and combination maintenance and reliever therapy (MART).

Bronchiolitis (infants and young children):

• Clinical diagnosis and criteria for hospital admission, including assessment of severity and risk factors.
• Supportive management, including oxygen therapy (standard and high-flow), and appropriate use of investigations and treatments such as chest X-ray and nebulized therapies.

The guidance is intended for policy-makers, programme managers, paediatricians, nurses, primary-care providers and frontline health workers across all levels of the health system. It emphasizes feasibility, affordability, equity and contextual adaptation, particularly in resource-limited settings. The recommendations form part of the evidence base for updating WHO child health tools and will be integrated into the WHO Pocket book of hospital care for children and the Integrated Management of Childhood Illness (IMCI) package, supporting implementation at primary care and first-referral hospital levels.