Executive Summary The Coronavirus disease 2019 (COVID-19) pandemic has triggered a global crisis and has affected millions of people worldwide. With the evolution of the different variants of concern, the incidence of COVID- 19 in the pediatric population has risen. The Surveillance and Analysis of COVID-19 in Children Nationwide (SALVACION) Registry, developed by the Pediatric Infectious Disease Society of the Philippines (PIDSP) and the Philippine Pediatric Society (PPS), has reported 3,221 cases as of March 31, 2022, with 90.4% requiring hospitalization and 36.2% with moderate to critical disease severity. Given the magnitude of the impact of COVID-19, with most of the clinical recommendations available designed towards adult patients, there was an urgent need for clinicians, public health officials and the government to also prioritize evidence-based clinical practice guidelines for the pediatric population. Hence, the development of the Philippine Pediatric COVID-19 Living Clinical Practice Guidelines was conceptualized. This independent project, funded and supported by the PPS and PIDSP, aimed to formulate up-to-date, evidence-based recommendations on the treatment, diagnosis, infection prevention and control of COVID-19 in children. Following the standard CPG development process outlined in the DOH Manual for CPG Development and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology, 15 evidence summaries and 24 recommendations were generated by 12 consensus panelists representing their specific health organizations and institutions.

BACKGROUND: One out of 10 Filipino children suffer from bronchial asthma. Its increasing prevalence over the past decades causes significant morbidity to the patients and their families, especially when it is uncontrolled. In developing countries, the form of medicine, cost and access to medications are significant factors in achieving good control of symptoms. No study has been done to determine if the use of low dose oral corticosteroid is a safe and effective alternative treatment for children with asthma.

OBJECTIVE: To compare the safety and efficacy of oral versus inhaled corticosteroid in moderate persistent asthma.

METHODS: An open label randomized controlled trial was carried out in 40 patients 6 to 15 years old with newly diagnosed moderate persistent asthma. They were assigned to either inhaled or oral corticosteroid group. Efficacy of treatment based on daytime and nighttime coughing, limitation of activity, use of bronchodilators, FEV1, PEFR and level of asthma control were assessed. Safety of both treatment options were evaluated by the occurrence of corticosteroid induced hypertension, adrenal insufficiency and diabetes.

RESULTS: The use of inhaled and oral corticosteroid showed improvement in daytime and nighttime cough, need for bronchodilators, limitation of activity, FEV1, PEFR and level of control. Furthermore, both treatment options had comparable safety profile.

CONCLUSION: There was no significant difference on the safety and efficacy of oral versus inhaled corticosteroid in the longterm treatment of moderate persistent bronchial asthma.

Human ; Asthma ; Randomized Controlled Trial ; Philippines