The five main unmet needs in the treatment of asthma in children and adoles
cents are the treatment of infants, the treatment of adolescents, the effic
acy of medication, the lack of clinical trials in children and the need for
prevention. Asthma is a dynamic disease that changes over time and there a
re several patterns of asthma in children. One of the greatest needs is to
identify those children with chronic asthma where undertreatment is more of
a problem than overtreatment. Although the treatment of asthma in children
is the same in principle as adults, there are several practical difficulti
es with infants, such as accurately assessing lung function and administeri
ng drugs. Teenage asthma creates a distinct management problem. Nor only is
asthma underdiagnosed but acceptance of diagnosis and compliance is often
poor. Existing therapies need to be used more effectively in adolescents. I
t is particularly important to establish a partnership with teenage asthmat
ics and motivate them to create their own treatment goals. This requires pa
ssing on knowledge. The efficacy of asthma medication may be different in c
hildren than in adults and clinical studies should be performed to optimize
therapy with existing drugs. The only proven primary preventive measure to
prevent wheezing and asthma is to avoid passive tobacco smoke exposure. Po
ssible intervention strategies include early intervention with antiinflamma
tory therapy, allergen avoidance and vaccine approaches but more of them ha
ve proven efficacious. Although modern asthma treatment has improved patien
t quality of life and long-term prognosis, there is still a need for furthe
r improvement.