Sir.—In his timely and informative article in the April 1989 issue of AJDC1 Dr Newcomb presents a survey of the current practices of experts in the treatment of childhood asthma.
Three quarters of his experts recommended home use of nebulized medication for 5-month-old and 18-month-old patients. Abuse or overdependence on inhaled adrenergics was mentioned by eight physicians.
Our use of the compressor-driven nebulizer is similar to that of the survey respondents. We have provided this treatment to more than 200 children at home. Our patients do not undergo treatment more often than every 4 hours without calling us. Parents monitor the status of young children by observing the four signs of asthma2 and checking the peak flow rate in children over 4 years of age.3 If the treatment does not produce a significant and steady improvement in signs and peak flow or the improvement does not