Document Detail


Randomized, controlled trial of inhaled budesonide as an adjunct to oral prednisone in acute asthma.
MedLine Citation:
PMID:  9523927     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the clinical effect of nebulized budesonide with placebo in acute pediatric asthma. METHODS: A randomized, controlled, double-blind trial with parallel design was used in the ED of a tertiary care children's hospital. Children aged 6 months to 18 years with a moderate to severe exacerbation of asthma [Pulmonary Index Score (PIS) > or = 5 or < or = 11 after a salbutamol nebulization of 0.15 mg/kg] were eligible. All patients received prednisone 1 mg/kg orally and nebulized salbutamol (0.15 mg/kg) every 30 minutes for 3 doses and then every hour for 4 hours. The intervention was 2 mg (4 mL) of nebulized budesonide or 4 mL of nebulized normal saline. RESULTS: Baseline characteristics were comparable in the budesonide group (n = 24) and in the placebo group (n = 20). There were no significant differences in the primary outcome measure (PIS) between the 2 groups. However, the PIS at 1 hour had a tendency to be lower in the budesonide group (median = 5) as compared with the placebo group (median = 6; p = 0.07). Survival analysis of release/discharge from the ED/hospital showed a more rapid rate in the budesonide group as compared with the placebo group (p = 0.02). No adverse effects were seen. CONCLUSION: Although these preliminary results suggest that nebulized budesonide may be an effective adjunct to oral prednisone in the management of moderate to severe asthma exacerbations, a larger trial will be required before the widespread use of inhaled budesonide in acute asthma can be advocated.
Authors:
L Sung; M H Osmond; T P Klassen
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine     Volume:  5     ISSN:  1069-6563     ISO Abbreviation:  Acad Emerg Med     Publication Date:  1998 Mar 
Date Detail:
Created Date:  1998-04-30     Completed Date:  1998-04-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9418450     Medline TA:  Acad Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  209-13     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, University of Ottawa, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Administration, Inhalation
Administration, Oral
Adolescent
Albuterol / administration & dosage,  therapeutic use
Anti-Inflammatory Agents / administration & dosage,  therapeutic use*
Asthma / drug therapy*
Bronchodilator Agents / administration & dosage,  therapeutic use*
Budesonide / administration & dosage,  therapeutic use*
Child
Child, Preschool
Double-Blind Method
Drug Therapy, Combination
Emergencies
Female
Hospitalization
Humans
Infant
Male
Nebulizers and Vaporizers
Prednisone / administration & dosage,  therapeutic use
Respiratory Function Tests
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Bronchodilator Agents; 18559-94-9/Albuterol; 51333-22-3/Budesonide; 53-03-2/Prednisone
Comments/Corrections
Comment In:
Acad Emerg Med. 1998 Sep;5(9):943-4   [PMID:  9754511 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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