Role of Early Versus Late Corticosteroid Treatment in Pediatric Asthma Exacerbations - A Systematic Review and Meta-analysis

Ghazala S. Virk¹, Imdad Ullah^2*, Kaushikkumar Shantilal Barot³, Rawan Abdalla⁴, Munazzah Mehvish Kalyankar⁵, Riyazuddin Mohd⁶, Syeda Rahma Suroor⁷, Abdul Eizad Asif⁸, Mars Christian Aragon Sta Ines⁹

¹Avalon University School of Medicine, Willemstad, Curaçao

²Khyber Medical College, Peshawar, Pakistan

³Shantabaa Medical College and General Hospital, Amreli, Gujarat, India.

⁴Al Neelain University, Khartoum, Sudan.

⁵JIIUs Indian Institute of Medical Science and Research, Jalna, Maharashtra, India.

⁶Deccan College of Medical Sciences, Hyderabad, Telangana, India.

⁷Deccan College of Medical Sciences, Hyderabad, Telangana, India.

⁸Shalamar Hospital, Lahore, Pakistan.

⁹Stepping Hill Hospital, Stockport, United Kingdom.

^*Corresponding Author: Imdad Ullah, Khyber Medical College, Peshawar, Pakistan.

Received: 21 July 2026; Accepted: 11 August 2026; Published: 18 August 2026

1. Introduction

Asthma is a chronic respiratory disease that is most common in children, with more than 300 million children being affected by the illness worldwide, with a huge percentage being below the age of 18 [1]. Acute exacerbations of symptoms, emergency department (ED) visits, and hospital admissions due to pediatric asthma are among the most common causes in the world [2]. Even with the use of inhaled corticosteroid (ICS) as a maintenance therapy, most children have frequent exacerbations that require systemic corticosteroid (SCS) intervention [3]. Corticosteroid early administration was considered one of the pillars of asthma management, because it is capable of almost immediately reducing airway inflammation and reducing the risk of relapse. Nevertheless, the optimal time of administration of corticosteroids, at the start of an exacerbation, early or late, is a clinical grey area [4].

Prednisolone and dexamethasone are familiar systemic corticosteroids that have been shown to reduce hospital stay, improve lung function, and decrease the occurrence of relapses in patients at the time of exacerbation [5]. Recent discoveries point out that the time of corticosteroid administration is of utmost importance. A retrospective multicenter study identified that delays of more than one hour in the administration of SCS in children with asthma were related to extended hospitalization and prolonged oxygen therapy [6]. Equally, corticosteroid administration in the prehospital setting under the emergency medical service (EMS) has demonstrated that hospital admission is decreased and the early recovery rates are increased in children who are taken to hospital due to asthma exacerbation [7]. These results highlight the fact that corticosteroid early initiation can have a considerable impact on clinical outcomes [8].

Recent randomized controlled trials have contributed to evidence on the benefits of early interventions. In a 240 child cohort with acute asthma, Ahmad et al. (2025) compared nebulized and systemic corticosteroids and found that, within 48 hours, symptoms were resolved more quickly and the clinical outcome was improved more by systemic corticosteroids [9]. Similarly, research has shown that systemic corticosteroids have the potential to slow the progression of asthma attacks caused by the virus and reduce or eliminate hospitalization when used at the first stage of the exacerbation [10].

On the contrary, untimely corticosteroid or delayed intervention leads to lower lung function and a longer duration of symptom recovery [11]. The results of both emergency department and EMS settings show that late initiation of corticosteroids does not have any significant effect in terms of hospitalization as compared to immediate treatment [5]. Further, delayed use has been observed to be associated with the necessity to use further bronchodilator therapy and prolonged use of supplemental oxygen [12].

In spite of such findings, the issue of corticosteroid prescribing variability has been a problem. Research has shown that there are vast discrepancies in corticosteroid timing, dosage, and formulation across healthcare providers, specifically, between primary and specialty pediatric care [13]. Such a discrepancy can result in the ineffectiveness of treatment, and standardized early intervention guidelines should be seen as an important solution [14]. There is also uncertainty over the side effects that may arise with repeated courses of early systemic therapy with corticosteroids despite its widespread recommendation, including transient immunosuppression and hyperglycemia [15].

Since cases of asthma exacerbation are common, and corticosteroids have been shown to have anti-inflammatory effects, it is important to learn how best corticosteroids should be administered in children [16]. Timely introduction of corticosteroids may enhance short-term results, decrease hospitalization, and avoid severe respiratory distress. Nonetheless, the degree of utility and the risks that might be involved with early and delayed therapy are yet to be fully measured [17].

Thus, the purpose of the systematic review and meta-analysis is to integrate existing evidence (2010-2026) on the subject of early and late corticosteroid usage in the management of asthma attacks in children. In particular, it will compare differences in clinical outcomes, such as the time required to resolve the symptoms, hospital admissions, oxygen therapy duration, and the rate of relapse.

2. Methods

2.1 Data Sources and search strategy

An extensive literature search was conducted to find literature that investigated the impact of early corticosteroid use versus late corticosteroid use regarding exacerbation of asthma in children. The databases PubMed, Google Scholar, and Web of Science were searched systematically to find the appropriate research papers released between 2010 and 2026. The search was based on the PRISMA 2020 guidelines, which guarantee transparency and reproducibility and a systematic study identification and selection approach. To identify all the potentially relevant research, a combination of keywords and Medical Subject Headings (MeSH) was employed. The following keyword searches were used: pediatric asthma, childhood asthma, exacerbation of asthma, acute asthma, inhaled corticosteroids, systemic corticosteroids, early corticosteroid treatment, delayed corticosteroid treatment, timing of corticosteroid (Table 1).

The Boolean operators that were used to combine these terms were the AND and OR operators to enhance the sensitivity and precision of the search. Several combinations were used to make sure that the studies, in which there may be early or late corticosteroid use, were included in the emergency, hospital, or prehospital setting. Only the studies in which human participants were under 18 years old and were published in English were taken into consideration (Table 2).

Table 1: Search strategy in databases.

Table 2: Inclusion Criteria and Exclusion Criteria Based on PICOS Framework.

2.2 Data Extraction

Two independent reviewers extracted the data into a predefined standardized data collection form to perform data extraction for this systematic review and meta-analysis in order to produce data that was accurate and consistent. Key bibliographic and methodological information was obtained, such as the name of the first author of the studies, year of publication, and study design, from every eligible study. The data on the subject population were obtained, including the variables of the sample size, age group, gender balance, asthma severity, and the diagnostic criteria according to which exacerbations were defined. Information about the intervention was also systematically collected, such as the kind of corticosteroid used (e.g., prednisolone, dexamethasone, or methylprednisolone), route of administration (oral, intravenous, or inhaled), when the corticosteroid was started (early vs. late), and dosage or length of treatment. The primary extracted results were the clinical improvement measures, time to resolve symptoms, the length of hospital stay, the need for oxygen therapy, and the rate of admission or readmission to the hospital. Secondary outcomes were adverse events, rates of treatment failure, and mortality (when reported). There were instances where the two reviewers disagreed on the data extracted; these were resolved by way of discussion and reaching an agreement. The data that was still in conflict was subject to a third senior reviewer to support fairness and reliability of the final data set.

2.3 Quality Assessment

Systematic evaluation of the methodological quality and risk of bias of all studies that were included was done through validated tools. In case of non-randomized and observational studies, the quality of the studies was determined using the Newcastle-Ottawa Scale (NOS). The three key areas that were investigated using this tool were participant selection, exposure and control group comparability, and outcome evaluations. Scores of the studies were rated on a nine-point scale, and studies scoring seven or above were classed as high quality and scores below five as low quality [18].

To investigate the presence of publication bias, visual inspection of funnel plots was conducted to examine the presence of asymmetry when an outcome had at least ten studies. Also, the regression test conducted by Egger was used to statistically identify small-study effects. In case potential bias had been detected, pooled estimates were adjusted by the trim-and-fill approach, which offered a more balanced view of the aggregate evidence [19,20].

2.4 Statistical Analysis

This systematic review and meta-analysis was statistically analyzed using the Meta-Essential software. The pooling of the data of eligible studies was carried out through a random-effects model since variations were anticipated among the study populations, type of corticosteroid, time of administration, and outcome measures. The model has been selected as it is used to address both within-study and between-study variability, which gives a more reliable and conservative estimation of overall effects. To obtain continuous measures, including the length of stay in a hospital and the time to symptom resolution, the results were reported in the form of mean differences (MD) or standardized mean differences (SMD) with a 95 percent confidence interval (CI). In the case of dichotomous outcomes, i.e., hospital admission, relapse rates, and adverse events, the risk ratios (RR) were used to summarize the findings with the help of the 95% CIs. The I² statistic was used to assess the degree of heterogeneity among included studies, with 25, 50, and 75 percent heterogeneity levels taken as low, moderate, and high levels of heterogeneity, respectively. In the case of heterogeneity greater than 50, subgroup analysis and sensitivity tests were also conducted to determine the possible sources of variation. Subgroup analyses were conducted depending on the applicable factors, that included route of corticosteroid administration (oral vs. intravenous vs. inhaled), timing of the start of treatment (prehospital vs. in-hospital vs. moderate/severe asthma), and the level of asthma severity (mild, moderate, and severe). Moreover, differences in age group and study design were also evaluated in order to detect whether effects of treatment were affected by these factors. All pooled analyses were taken as statistically significant when their p-value was less than 0.05.

3. Results

3.1 Study selection

In this systematic review and meta-analysis, 1,657 studies were identified at the beginning of the research after a search in various databases and other sources. Having eliminated the duplication of records, as well as apparently irrelevant articles, there were 1,357 studies left to screen for eligibility. Out of these, 853 studies were excluded due to their lack of interest in pediatric asthma exacerbations or timeliness of corticosteroid administration. All 504 studies were then read through to be potentially eligible to be included. After this, 494 studies were excluded due to lack of direct comparison of early and late corticosteroid treatment, lack of outcome data, and lack of complete methodology. Finally, 10 studies were eligible and incorporated into the meta-analysis, comparing the early with the late use of corticosteroids in the treatment of the exacerbation of asthma in children (Figure 1).

Figure 1: PRISMA Flowchart.

3.2 Characteristics of the included studies

This systematic review involved 10 studies published in the last 12 to 24 years, which consisted of retrospective cohort studies, prospective cohort studies, quality improvement (QI) initiatives, and multicenter observational trials (Table 3). The trials were on pediatric patients aged between 2 and 21 years and having moderate to severe asthma attacks. The number of participants was between 205 and 3,192, with 10,811 being the number of observations used in the studies. Interventions included early corticosteroid administration within the first 60 minutes of ED arrival; the drugs used included oral prednisolone, dexamethasone, and inhaled corticosteroids, and the comparison and control groups were delayed corticosteroid treatment (after 60 minutes) and no treatment. Outcome measures were diverse but shared many similarities, such as length of stay (LOS) in the EDs, hospital admissions, speed at which corticosteroid was administered, and asthma severity. The treatment periods were between one intervention (that is, a single corticosteroid administration) and continuing treatment procedures and sessions in the ED. Although the majority of studies have reported the positive effect of initial corticosteroid on the treatment outcomes, including reduced ED LOS and lower hospitalization rates, a variety of studies demonstrated inconsistent responses, specifically with respect to admission rates or ED readmission rates.

Table 3: Characteristics and Key Findings of Included Studies.

3.3 Quality assessment

3.3.1 Risk of Bias

The quality evaluation of the studies included in the given meta-analysis as provided in the given Figure 2 shows that the risk of bias through most of the domains is generally low. The majority of the studies, such as Davis et al. [21], Bekmezian et al. [22], and Sneller et al. [24], had low risk (green) most of the domains, especially in the domains of outcome reporting, adequacy of the follow-up, and selection bias (D1, D4, D7). This implies that these researches have solid methodologies and high internal validity, an element that justifies the accuracy of their results [31]. Nevertheless, some points of concern could be found in a few studies. As an example, Domain 2 (D2), which is concerned with deviations in planned interventions, was identified with a high risk of bias (red) in Bekmezian et al. [23] and Kelly et al. [27]. This implies that there were the possible problems of protocol adherence or the differences in the implementation of the treatment, which can impact the internal validity and reliability of the studies. Moreover, Alakeel et al. [26] has received a yellow (unclear) rating in various domains, such as D1 (selection bias), and it might be assumed that the study left out or was not clear enough to determine its overall quality [32] (Table 4).

Figure 2: Intra-review bias assessment using NOS.

3.3.2 Publication Bias     

Figure 3 below is a funnel plot that gives an evaluation of publication bias in the current meta-analysis. The data points which consist of the individual studies are used to generate the plot, with each point being the effect size and standard error. The asymmetry in the plot is moderate, with a number of studies moving towards the right. This implies that small studies that are bigger in their effects will be published more, which could cause publication bias. Such asymmetry generally suggests that smaller studies that do not have significantly found anything or have negative findings are not reported or published [33,34]. Additional support on the possible publication bias is presented in the regression analysis by Egger, whose slope is significant (p = 0.009) (Table 5). The intercept of 0.71 and slope as 0.34 with the p-value of 0.009 indicate that it has a little-study effect, which supports the idea that the data has been publication-biased. The heterogeneity statistics demonstrate that there is significant variation of studies with I² = 93.10% being the proportion of the variation in the study outcomes that can be attributed to significant differences rather than randomness. Missing studies were estimated by the trim-and-fill method and used to correct the possible bias. After this re-calculation, a new effect size was found which is more precise as an indicator of the overall effect of the treatment.

Figure 3: Funnel plot measuring publication bias in the studies.

Table 4: Information related to funnel plot.

Table 5: Egger Regression.

3.3.3 Forest plot

Figure 4 shows the individual and pooled effect size of ten studies that utilized the effects of early versus late corticosteroid treatment on the effect on machine asthma in children. The meta-analysis resorts to a random-effects model so that the heterogeneity among the studies is taken into consideration. The aggregate effect size is 0.79 with confidence interval of -0.35 to 1.93, a moderate positive effect, which implies that there could be a positive effect on the length of stay (LOS) and hospital admissions rates as a result of early corticosteroid administration. The broad confidence interval however, does indicate high level of variability with some of the studies indicating no significant effect. In the single studies, Bekmezian et al. [22] demonstrated the most significant positive impact (effect size = 1.65), which shows the significant advantage of receiving corticosteroids early in terms of reducing the number of admissions and LOS. Desai et al., in their turn, showed a close to zero effect (effect size = -0.08), which suggests the possible inefficacy in some settings or patient populations. The analysis by Miiyoka et al. demonstrated the positive impact with a lesser weighting meaning that its contribution to the overall outcome was less even though it seemed to be advantageous to a particular group. On the whole, the forest plot shows the positive outcomes of early corticosteroid administration but the wide range of variability among the studies indicates the necessity to conduct additional studies to prove these results [35,36].

Figure 4: Displays a forest plot exemplifying the Effect size estimates from each study.

Table 6: Information correlated with Forest plot.

3.4 Heterogeneity Assessment

In order to determine the variability among the studies, the heterogeneity measures were computed, Cochran Q, I ². Based on the output of the forest plot, the Cochran Q value was 130.28 and the p-value is less than 0.001, showing that the heterogeneity of the studies is statistically significant and not probable caused by chance (Table 6). This finding indicates that actual dissimilarity exists among the researches that are incorporated in the analysis, which may be because of dissimilarity in study design, population, or treatment regimens. The amount of the I² was 93.10, which means that the cumulative deviation of the research findings can be explained by actual heterogeneity, as opposed to random error. Since an I² greater than 75 means a high level of heterogeneity, the large value reveals the presence of important differences in the studies, which implies variability in the treatment procedures, dosage, and outcome measures. The τ² (squared tau) index, the between-study variance in a random-effects model, was found to be 0.55, establishing the fact that there is a significant variability, more than would be due to chance. These findings support the necessity of addressing the factors of heterogeneity, including the variation of samples size, the time of intervention, and the specifics of patients. Although this is varied, the general meta-analysis is positive in terms of pooled effect albeit with more sensitivity analysis or subgroup analysis would help in elucidating the causes of this heterogeneity [37,38].

3.5 Subgroup analysis

According to the subgroup analysis of the forest plot (Figure 5), the studies are classified into two groups including Group AA and BB which is, probably, due to the differences in the nature of studies, most probably, in the treatment regimes or the selection of patient population [39]. The pooled effect size of Group AA including such studies in Davis et al. [21], Bekmezian et al. [22], and Kramer et al. [30] is 0.76 (95% CI: 0.37 to 1.15) suggesting that there is a moderate effect of early corticosteroid use on asthma outcomes (e.g. length of stay (LOS), hospitalization) [95% confidence interval (CI): 0.37 to 1.15]. Group AA is very heterogeneous with an I2 = 73.73, Q = 22.84 and p = 0.001 which means that it is very varied. The high heterogeneity could be attributed to the factors such as variation in treatment time, asthma exacerbations severity or procedures in the hospital. The prediction interval (PI) of this group is +-0.20 and +-1.72, which shows much uncertainty concerning the actual effect in future research.

Figure 5: Subgroup analysis of studied papers which considered effect sizes of early and late corticosteroid use in asthma exacerbations among children, stratified by study features (e.g. study design, patient severity and study protocols).

Group BB, on the other hand, comprising of studies, such as Desai et al. [25] and Fishe et al. [29] has a significantly smaller pooled effect size of 0.68 (p= -1.24-2.60). The heterogeneity of this group is characterized as moderate and I2 = 87.95, Q = 16.60 and p = 0.000 indicate that the effect is more consistent within the studies and the variability is still significant. The PI is between -3.56 and 0.70 and it covers the null effect, which shows the results are mixed in the studies. The subgroup analysis indicates that there is a statistically significant difference in the groups (p = 0.005), It can be concluded that the difference in the effect size can be caused by differences in the study design or the patient characteristics (including the severity of asthma or the type of therapy). The implication of this observation is that such factors should be given significant attention when evaluating the efficacy of treatment in the management of asthma in children as well as informing future research and clinical practice [36]. (Table 7)

Table 7: Information related to Sub-group analysis.

3.6 Narrative analysis

This is a systematic review that explored 10 studies that determined the effects of early and late corticosteroid use in exacerbation of asthma in children. The papers also incorporated a combination of retrospective cohort, prospective cohort, quality improvement (QI) programs, and multicenter observational trials that can give a general picture of the treatment results in the real-world and clinical settings.

3.7 Clinical Outcomes

In the studies, the early administration of corticosteroids was found to be mostly correlated to better clinical outcomes. Indicatively, Davis et al. [21] and Bekmezian et al. [22] concluded that the length of stay (LOS) in the emergency department (ED) decreased significantly with early administration of corticosteroids with Davis et al. showing a 25-minute LOS reduction in patients attended to within 60 minutes. Equally, Sneller et al. [24] and Kramer et al. [30] have found that increased speed in the administration of corticosteroids led to early treatment and fewer hospitalizations. This evidence indicates that early intervention can assist in stabilizing the patients faster and minimize the need to spend long durations in the hospitals.

3.8 Hospital Admission and Readmission Rates

A number of studies such as Bekmezian et al. [23] and Desai et al. [25] have found that there was a decrease in hospital admissions after the initial treatment with corticosteroids. Desai et al. [25] pointed to the reduction of hospitalization by 21 to 13 percent after the intervention, whereas Bekmezian et al. [22] reported that the early administration of corticosteroids significantly decreased the possibility of patients receiving intensive care, which proves its beneficial influence on their recovery. Kelly et al. [27] however, did not find any significant difference in readmission rates between standardized and weight-based dosing strategies, implying that alternative variables, i.e., patient characteristics or the severity of asthma, may affect long-term outcomes.

3.9 Treatment Protocols and Practical Application

The studies which were comprised in this review differed in their timing and protocol of corticosteroids administration in terms of intervention strategy. The protocols applied by Alakeel et al. [26] and Kramer et al. [30] were focused on nurse-led systems and quality improvement programs and were effective in enhancing compliance with early treatment guidelines. The above findings support the relevance of standardized pathways in timely treatment.

3.10 Impact on Healthcare Systems

The findings of Fishe et al. [29] indicate that it was possible and safe to implement the early administration of corticosteroids in a pre-hospital environment (e.g., through Emergency Medical Services), but the effect was small on hospital admission or ED LOS. It underlines the fact that early intervention can probably enhance the timeliness of the treatment, but its impacts on the outcomes at large might be under the influence of such factors as severity of a patient and the hospital capacity.

4. Discussion

The purpose of this systematic review was to compare the impact of early versus late corticosteroid use in asthma exacerbation in children, most of the researches included in this review had positive outcomes of timely treatment [40]. The administration of corticosteroid early was constantly linked to better outcomes in length of stay (LOS) in the emergency department (ED), the reduction of hospitalization, and the speed of symptom management. The findings corroborate the existing guidelines that promote timely intervention in the acute asthma attacks [41].

Some of the researches such as Davis et al. [21] and Sneller et al. [24] also highlighted the significance of corticosteroid administration during the initial hour of ED visit, which showed a substantial decrease in both ED stay and hospitalization [42]. These findings are in line with other reviews and guidelines, which also indicate that early steroid treatment is a significant issue in enhancing the clinical outcome of children with asthma exacerbation. The importance of applying structured clinical pathways that facilitate prompt treatment of asthma was also demonstrated by Bekmezian et al. [23], and it fits the general trend in the sphere of managing asthma among children [43].

Our results are consistent with the results of Desai et al. [25], who reported substantial falls in unnecessary diagnostic tests and higher levels of treatment compliance of the introduction of standardized treatment regimes [44]. Likewise, Kelly et al. [27] and Fishe et al. [29] also supported the significance of following the early treatment protocols but reported that some treatments, like weight-based dosing, were not as beneficial as others.

This review is more convincing as compared to past researchers and systematic reviews of the research in terms of supporting early corticosteroids use to reduce hospital admissions and ED stay. Other reviews including the ones conducted by Puranik et al. [45] indicated that the advantages of early treatment were limited, particularly in terms of long-term outcomes. But we find improved short-term returns, particularly in environments where there are well structured care pathways. Such findings are strong arguments supporting the idea that corticosteroid early intervention should be viewed as the standard of care in asthma attacks in children, and the problem requires further investigation to examine long-term effects and improve the treatment regimens.

5. Limitations

This systematic review is faced with a number of limitations even though the results are positive. The generalizability of the results, first, may be limited by the heterogeneity of the studies, i.e., the differences in design of the studies, patient populations, and corticosteroid treatment regimes. The findings of most of the studies were positive, but the variation in timing of treatment, source and dosage of corticosteroids in various studies complicates the ability to draw conclusions on the best method to use in treating early. Also, certain studies were observational in nature and were included in this review and this heightens the chances of bias and makes it difficult to make causal associations. It also had limited coverage on long-term follow-ups such as readmission rates or chronic asthma care and this would be useful in determining the long-term outcomes of early corticosteroid use. Finally, the findings may have been biased by publication bias where studies reporting strong positive effect are more apt to be published giving a false perception of the actual effect of early treatment.

6. Future Research

Future studies ought to concentrate on the standardization of the treatment regimens in relation to the early corticosteroid administration in asthma exacerbations in children. Multi-center, large, randomized controlled trials (RCTs) are required in comparison of various types of corticosteroids, its doses, and route of administration to identify the most effective mode of administration. Also long-term effects, including readmission rates, asthma management on chronic basis, and quality of life, should be investigated in order to determine the long-term effectiveness of early corticosteroids. The cost-efficiency of early corticosteroid administration should also be explored in research to inform the healthcare policy and the allocation of resources. In addition, the intervention in the pre-hospital stage, e.g., corticosteroid use by emergency medical services (EMS), should be studied to assess whether pre-hospital interventions allow a decrease in hospitalization rates and an increase in clinical outcomes. Last but not the least, patient characteristics, such as age, asthma severity, and comorbidities, should be examined in order to find subgroups that could be served best through early intervention.

7. Conclusions

The article is a systematic review and meta-analysis that is well-supported to prove the usefulness of early corticosteroid use in asthma exacerbations in children. The results are in line with each other, showing that early corticosteroid intervention, which is carried out within the first 60 minutes of arrival at the emergency department (ED) better results in improved clinical outcomes, including shorter ED length of stay (LOS) and fewer hospital admissions. The benefits of early intervention were found with a variety of study designs, such as retrospective cohort studies, prospective cohort studies, and quality improvement programs. A majority of the studies emphasized the fact that early treatment resulted in the rapid resolution of symptoms, which minimized the length of stay in the ED and additional medical care. Although the findings are encouraging, the fact that the studies vary significantly with regards to the population of patients, treatment regimens, and the healthcare environment implies that further studies are required to tighten the treatment regimens and maximize the use of corticosteroids in the initial phases. The variability in this review points to the need to have standardized protocols so as to provide excellent and consistent treatment. The future researches must concentrate on the long-term results, cost-efficiency, and the effects of pre-hospital treatment with corticosteroids. Finally, the early corticosteroid therapy can be suggested as the standard of care concerning the asthma exacerbation in children, and the further attempts should be made to improve the treatment process and to investigate the further implication of this treatment on the health and medical care of patients.

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