Effectiveness and safety of inhaled corticosteroids in controlling acute asthma attacks in children who were treated in the emergency department: A controlled comparative study with oral prednisolone☆,☆☆,★,★★
Section snippets
METHODS
The study population included children aged 6 to 16 years with well-diagnosed asthma who were treated in the ED with a moderately severe acute asthma attack, defined by a peak expiratory flow rate (PEFR) of 35% to 75% of predicted values and a pulmonary index score4 of 8 to 13 (maximal score, 15). Other prerequisites were the ability to correctly operate the turbohaler; the absence of acute febrile illness; freedom from regular treatment with antiasthma controller drugs including inhaled
RESULTS
Twenty-four children who were treated in the ED with an acute asthma attack started the trial; 1 child was later excluded because of pneumonia, and another for noncompliance. Of the 22 children who completed the study, 11 were treated with inhaled budesonide and 11 with oral prednisolone. The 2 groups were similar for demographic parameters, asthma morbidity in the 3 months preceding the study, and asthma status after the onset of the index asthma attack (Table II).
There were no significant
DISCUSSION
International guidelines on asthma management recommend a short course of 1 to 2 mg/kg/day of oral or intravenous prednisolone with β2 agonists for the treatment of acute severe asthma.16, 17 Some studies have found that a single administration of high-dose intravenous6 or oral4, 18 corticosteroids is also effective in controlling acute asthma attacks within 4 hours in both adults6 and children.4, 18 This was not confirmed by others.7, 8 Barnett et al9 reported that 2 mg/kg oral
Acknowledgements
We thank Mrs Gloria Ganzach for editorial assistance.
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Cited by (0)
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From a the Asthma Clinic, Department of Pediatrics C, Schneider Children’s Medical Center of Israel, Petah Tikva, Sackler School of Medicine, Tel Aviv University; and b the Pediatric Pulmonary Unit, Rambam Hospital, Technion Israel Institute of Technology, Faculty of Medicine, Haifa.
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Supported in part by Astra-Draco, Sweden.
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Reprint requests: Benjamin Volovitz, MD, Head, Asthma Clinic, Department of Pediatrics C, Schneider Children’s Medical Center of Israel, 14 Kaplan St, Petah Tikva 49202, Israel.
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0091-6749 $5.00 + 0 1/1/92477