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Background Asthma accounts for about one in every 250 deaths worldwide. Many of the deaths are preventable, being due to suboptimal long-term medical care and delay in obtaining help during acute exacerbation. Aim to assess knowledge, attitude and practice of Egyptian physicians about childhood asthma exacerbation treatment guidelines and to identify the barriers against application of guidelines in different hospital settings in Egypt. Methods a written questionnaire with different topics were added aiming at assessment of four important aspects about the involved physicians; physician's knowledge, practice, attitude and barriers against application of guidelines. This questionnaire was fulfilled by 200 pediatricians, all of them deal with childhood asthmatics. As regards Academic degrees, 94 (47.7%) had the Bachelor degree, 70 (35.5%) had Master degree, 23 had Diploma degree (11.7%), and 10 (5.1%) had Doctorate. As regards Hospital settings, 102 (51.8%) of the pediatricians were working in governmental hospitals, 76 (%38.6) of them were working in University hospitals, 13(6.6%) pediatricians worked in private hospitals and 6 (3%) pediatricians worked in other types of hospitals. Results low level of knowledge was found in 80.2% of participants, non adherence to guidelines was found in 59.4 % and negative attitude towards guidelines was found in 65.3% of them. Conclusion Most of the studied physicians have low level of knowledge, non adherence to guidelines and negative attitude towards guidelines. The main barriers against guideline application were the external barriers followed by patient related barriers then personal barriers. Guideline related barriers were in the last rank. So, Continuous training of physicians, increasing people’s awareness and improving facilities in hospitals are required to get better adherence to guidelines

Assessment of the current practice of asthma exacerbation management in different health settings in Egypt