K.D. is a 3-year-old girl who presents to her pediatrician with wheezing and shortness of breath. Her mother reports that K.D. has been given a diagnosis of pneumonia twice in the past year. Her mother also reports that K.D. awakens coughing 1 night a month and that, the last time she received a diagnosis of pneumonia, she had to use the albuterol inhaler she was given about three times weekly. The pediatrician gives K.D. a diagnosis of asthma. Which is the best treatment for K.D.?
a. Continue albuterol as needed for symptoms.
b. Add budesonide 0.5 mg nebulized twice daily.
c. Add beclomethasone hydrofluoroalkane (HFA) 80 mcg 2 puffs twice daily.
d. Add fluticasone 44 mcg 2 puffs twice daily.