Position paper on aerosol therapy in childhood: a statement proposed by the SIMRI Asthma Committee and approved by the SIMRI Advocacy Council and Executive Committee

ABSTRACT

Aerosol therapy represents a cornerstone in the management of respiratory diseases in pediatric patients. By enabling the direct delivery of medications to the airways, this modality ensures a rapid onset of action while minimizing systemic side effects. It is particularly valuable in the treatment of conditions commonly affecting children, such as recurrent wheezing, asthma, and croup, as well as orphan or complex diseases including cystic fibrosis, primary ciliary dyskinesia (PCD), and post-infectious bronchiectasis.

In pediatric practice, aerosol therapy offers several advantages, including improved therapeutic efficacy at lower doses and superior tolerability compared with systemic administration. However, the clinical effectiveness of this intervention is contingent upon multiple factors, such as the patient’s age and degree of cooperation, respiratory pattern, and the appropriate selection and correct utilization of inhalation devices. Consequently, comprehensive education for both caregivers and healthcare professionals is essential to optimize therapeutic delivery and clinical outcomes. Overall, aerosol therapy is a safe, effective, and widely used strategy in pediatric respiratory management, contributing significantly to symptom control and quality of life in both acute and chronic conditions.

This statement summarizes current evidence and presents the official recommendations of the Italian Pediatric Respiratory Society (Società Italiana per le Malattie Respiratorie Infantili – SIMRI) to guide best practices for aerosol therapy throughout childhood.

KEY WORDS

Aerosol therapy; nebulizer; pMDI; spacer; dry powder inhaler; pediatrics.