For a child with episodic wheezing and a history of atopic dermatitis, what is the most appropriate next step in management after a bronchodilator trial shows improvement?

The most appropriate next step in the management of a child with episodic wheezing who demonstrates improvement after a bronchodilator trial is to continue using albuterol, the short-acting bronchodilator. Albuterol works by relaxing the muscles in the airways, making it easier to breathe, and is effective for immediate relief of wheezing symptoms. If the child shows improvement with this trial, it indicates that their wheezing is likely related to bronchospasm that can be addressed with ongoing use of albuterol as needed.

In this scenario, maintaining access to a quick-relief medication is essential for managing acute wheezing episodes effectively. Albuterol serves as a rescue inhaler that can be used during exacerbations or when symptoms arise.

In contrast, while oral corticosteroids might be necessary for managing severe inflammation or prolonged exacerbations, they are not appropriate for routine use or management of episodic symptoms without further exacerbation or severe symptoms. Leukotriene receptor antagonists, on the other hand, may also be used for asthma management, especially if there is an underlying asthma diagnosis, but they are not the immediate next step following a bronchodilator trial indicating responsive bronchospasm. Long-acting bronchodilators are typically reserved for more chronic control