Childhood Asthma Research and Education (CARE) Network Trial - Acute Intervention Management Strategies (AIMS)

Inclusion Criteria: * Recurrent episodes (at least two) of wheezing in the context of a RTI, at least one of which must be documented by a health care provider (parental report) over the 12 months prior to study entry, and of which one episode must have occurred within 6 months prior to study entry * Either two episodes of '1,' OR two episodes of '2,' OR one episode of '1' AND one episode of '2,' defined by the following: 1. Urgent care visit for acute wheezing (emergency department, urgent care center, or unscheduled primary care physician office visit), which required treatment with a bronchodilator, within 12 months prior to study entry 2. Episode of wheezing within 12 months prior to study entry, which required treatment with oral corticosteroids not associated with a visit to a health care provider, urgent care center, emergency department, or hospital * Immunizations are up to date, including varicella (unless the patient has already had clinical varicella) * Willingness to provide informed consent by patient's parent or guardian Exclusion Criteria: * Use of more than six courses of systemic corticosteroids during the 12 months prior to study entry * More than two hospitalizations for wheezing illnesses within 12 months prior to study entry * Use of long-term controller medications for asthma (including inhaled corticosteroids, leukotriene modifiers, cromolyn/nedocromil, or theophylline) for 4 or more months (cumulative use) within 1 year prior to study entry * Any use of long-term controller medications for asthma (including corticosteroids \[inhaled or oral\], leukotriene modifiers, cromolyn/nedocromil, or theophylline) within the 2 weeks prior to the enrollment visit * Current treatment with antibiotics for diagnosed sinus disease * Contraindication of use of systemic corticosteroids * Prematurity (defined as birth before 36 weeks gestational age) * Presence of lung disease other than asthma (e.g., cystic fibrosis and BPD) * Presence of other significant medical illnesses (e.g., cardiac, liver, gastrointestinal, or endocrine disease) that would place the patient at increased risk * Gastroesophageal reflux under medical therapy * Immunodeficiency disorders * History of respiratory failure requiring mechanical ventilation * History of hypoxic seizure * Inability to cooperate with nebulization therapy * Inability to ingest the study drugs * History of significant adverse reaction to any study medication ingredient * Current participation, or participation in the month prior to study entry, in another investigational drug study * Evidence that the family may be unreliable, nonadherent, or likely to move from the clinical center area before study completion * Persistent symptomatic asthma, as defined as experiencing symptoms (i.e., nocturnal cough, daytime cough, wheezing, difficulty breathing, or symptoms interfering with activities) and/or requiring albuterol use on average 4 or more days per week in the 2-week observation period prior to the randomization visit * The following scores, based on a 5-point scale with 5 representing very severe symptoms (measured at randomization visit): score equal to or greater than one for albuterol use, wheezing, difficulty breathing, nighttime cough, and asthma symptoms interfering with activities; score greater than 2 for daytime cough on an average of 4 or more days/week during the 2-week observation period * Failure to complete diary cards at expected levels (at least 80% of days) during the observation period * Use of long-term controller medications for asthma (e.g., corticosteroids \[inhaled or oral\], leukotriene modifiers, cromolyn/nedocromil, or theophylline) during the 2-week observation period