Do not use salmeterol in children with acute asthma.

Type of practice


Topic Area


In children with acute asthma, long-acting beta2-agonists (LABAs) are not recommended, because of slow onset of action (10-20 minutes). Clinical data on safety in children are really limited. Moreover, in children with acute asthma salmeterol monotherapy increases the risk of hospitalization and the need for invasive ventilation. In children with acute asthma short-acting beta2-agonists (SABAs) are recommended, even with repeated doses and combined with anticholinergic medications. Supplementary oxygen and early systemic steroids are also recommended.


1. Global Strategy for Asthma Management and Prevention (GINA), 2016 update.
2. Fergeson JE et al. Acute asthma, prognosis, and treatment. J Allergy Clin Immunol 2017 Feb; 139 (2): 438-47.
3. Liao MM et al. Salmeterol use and risk of hospitalization among emergency department patients with acute asthma. Ann Allergy Asthma Immunol 2010 Jun; 104 (6): 478-84.
4. Stempel DA et al. Safety of adding Salmeterol to Fluticasone Propionate in children with Asthma. N Engl J Med 2016 Sep 1; 375 (9): 840-9.
5. BTS/SIGN British guideline on the management of asthma, 2016.

Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.