Article
Inhaled salbutamol for wheezy infants: a randomised controlled
trial
R J Chavasse, Y Bastian-Lee, H Richter, T Hilliard, P Seddon
The Royal
Alexandra Hospital for Sick Children, Dyke Road, Brighton BN1 3JN,
UK
Correspondence to: Dr Chavasse email: rah{at}mistral.co.uk
Accepted 20 January
2000
BACKGROUND
Salbutamol is frequently
used as a bronchodilator for infants who wheeze. Many single dose
studies have questioned its effectiveness.
AIMSTo investigate the response of
wheezy infants to salbutamol over an extended time period in order to
elucidate either symptomatic relief or a protective effect.
METHODSEighty infants under 1 year, with persistent or recurrent wheeze and a personal or family
history of atopy, were recruited to a randomised, double blind, cross
over, placebo controlled trial. Salbutamol (200 µg three times daily)
or placebo were administered regularly over two consecutive treatment
periods of four weeks via a spacer and mask. Symptoms of wheeze and
cough were recorded in a diary. At the end of the study pulmonary
function tests were performed before and after salbutamol (400 µg).
RESULTSForty eight infants
completed the diary study; 40 infants underwent pulmonary function
testing. No difference in mean daily symptom score was observed between
the salbutamol and placebo periods. There was no difference in the
number of symptom free days. Compliance and forced expiratory flows
remained unchanged and resistance increased following salbutamol. There
was no relation between the response measured by symptom score or
pulmonary function in individual patients.
CONCLUSIONIn wheezy infants with
an atopic background, there was no significant beneficial effect of
salbutamol on either clinical symptoms or pulmonary function. Clinical
effects could not be predicted from pulmonary function tests.
Salbutamol cannot be recommended as the bronchodilator of choice in
this age group.
Keywords: persistent wheeze; diary score; pulmonary function test
© 2000 by Archives of Disease in Childhood
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