Salbutamol and Corticosteroid Therapy in Preschool Wheeze: A Systematic Review

Objective The aim of the review is to determine the effectiveness of salbutamol as compared to salbutamol in combination with corticosteroids in the treatment of acute wheezing in preschool-aged children. Methods A systematic literature review was carried out in PubMed, Web of Science, and Scopus to retrieve peer-reviewed journal articles published between 2009 and October 2025. Inclusion criteria were original clinical studies assessing salbutamol-based interventions, with or without corticosteroid use, in preschoolers presenting with acute wheezing but untested with a formal diagnosis of asthma. Only peer-reviewed journal articles were considered, and unpublished data in clinical trial registries were not included. Results Fifteen studies were included, comprising randomised controlled trials, cohort studies, and observational studies conducted in various countries, including Chile, Egypt, Finland, Turkey, Italy, the Netherlands, and Israel. Several studies found that oral or inhaled corticosteroids, combined with salbutamol, decreased hospital admissions, improved the clinical severity scale, and reduced symptom duration, with minimal effects on cortisol. Nevertheless, no added value was reported in other studies. Discussion The variation in findings across studies appears to be due to heterogeneity in wheeze phenotypes, disease severity, timing of corticosteroid therapy, and route of administration, indicating that preschool children with wheeze do not respond uniformly to treatment. Conclusion Selective use of corticosteroids offers benefits for some preschool wheezing episodes, whereas universal administration risks unwanted complications. Further research should focus on biomarker-based interventions and standard treatment regimens to optimise outcomes. INPLASY Registration Number INPLASY2025100040.