Bibliographic information
GuidelineWHO consolidated guidelines for the management of common childhood illness: management of asthma in children and adolescents and bronchiolitis in infants and young children
Year of Publication2026
Issuing InstitutionWorld Health Organization
Recommendation
Updated
Intravenous (IV) aminophylline should not be used as second-line therapy for severe paediatric asthma exacerbations in health care facilities if alternative second-line options are available.
Recommended against
Conditional
Certainty of evidence
Low
Notes and Remarks
- The restricted use of aminophylline should be accompanied by the availability of appropriate inhaled SABA and systemic corticosteroids for the management of acute asthma exacerbation across all settings.
- In resource-restricted and rural settings, aminophylline may be the only available agent for the management of acute asthma exacerbations.
- If the decision is made to use aminophylline, adequate monitoring and anti-emetics should be used to mitigate the risk of side-effects.
- The restricted use of aminophylline should be accompanied by ensuring availability of inhaled SABA and systemic corticosteroids for the management of acute asthma exacerbation across all settings.
- It is important that a recommendation against the use of IV aminophylline should not disadvantage resource-restricted and rural settings where aminophylline may be the only available agent for the management of acute asthma exacerbations.
- If the decision is made to use aminophylline, adequate monitoring and anti-emetics should be used to mitigate the risk of side-effects.
- Children receiving aminophylline require clinical monitoring including heart rate, respiratory rate, electrocardiogram (ECG) and neurological observations.
- Where available, blood gases and serum aminophylline/theophylline concentrations should be considered in those already receiving oral therapy and on prolonged treatment (23).