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Treatment of intermittent and mild persistent asthma in adolescents and adults

Christopher H Fanta, MD
Section Editor
Bruce S Bochner, MD
Deputy Editor
Helen Hollingsworth, MD


A basic tenet of asthma therapy is that the intensity of treatment should match the severity of asthmatic symptoms. As a result, patients with infrequent and mild symptoms of asthma should be treated intermittently with the goal of quick symptom relief. Patients with mild symptoms that are persistent or present regularly should additionally receive a long-term controller medication. Likewise, patients with mild, intermittent symptoms whose asthma often (more than two times per year) flares into attacks requiring oral glucocorticoids are encouraged to take daily controller medication to prevent these attacks. As with all types of asthma, effective communication, ongoing patient education, and regular reassessment of asthma control are crucial for long-term success.

The issues relating to the treatment of intermittent and persistent mild asthma in adults and adolescents will be discussed here, with an emphasis on pharmacologic therapy. The recommendations made in this review are based upon the National Asthma Education and Prevention Program (NAEPP) guidelines, as well as similar guidelines published by the Global Initiative for Asthma [1,2]. An overview of the management of asthma, and reviews of the treatment of other severities of asthma, are presented separately. (See "An overview of asthma management" and "Treatment of moderate persistent asthma in adolescents and adults" and "Treatment of severe asthma in adolescents and adults".)


Mild asthma may be classified as intermittent or as mild persistent. Classification of asthma in general is based upon an assessment of current impairment of function and future risk of exacerbations, with the latter based on the number of serious exacerbations within the past year [1]:

Reported daytime and nighttime symptoms and exercise limitation over the previous two to four weeks

Current values of peak expiratory flow (PEF) or forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FEV1/FVC) (see "Peak expiratory flow rate monitoring in asthma" and "Office spirometry")

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Literature review current through: Nov 2017. | This topic last updated: Sep 07, 2017.
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