A comparative study on the effect of nebulized budesonide and levosalbutamol versus ipratropium bromide and levosalbutamol in the management of acute asthma in children aged 5-11 years

Authors

  • Jose P. Cyril Department of Pediatrics, Dr Somervell Memorial CSI Medical College, Karakonam, Trivandrum, Kerala, India
  • Baburaj S. Department of Pediatrics, Dr Somervell Memorial CSI Medical College, Karakonam, Trivandrum, Kerala, India
  • Priya S. Nair Department of Pediatrics, Dr Somervell Memorial CSI Medical College, Karakonam, Trivandrum, Kerala, India
  • Tinu A. Kuruvilla Department of Pediatrics, Dr Somervell Memorial CSI Medical College, Karakonam, Trivandrum, Kerala, India
  • Bobby C. Department of Pediatrics, Dr Somervell Memorial CSI Medical College, Karakonam, Trivandrum, Kerala, India
  • Lini B. Das Department of Pediatrics, Dr Somervell Memorial CSI Medical College, Karakonam, Trivandrum, Kerala, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20205507

Keywords:

Peak expiratory flow rate, Pulmonary score

Abstract

Background: Asthma is a non-communicable chronic inflammatory condition of lung airways. The availability of new diagnostic methods, introduction of a number of drugs, both oral and inhaled has revolutionized management of asthma in children. Goal was to achieve maximum effect with least amount of medication and allowing infrequent use of quick relievers. The present study was, therefore, designed to compare the effectiveness of single dose nebulization with combination of nebulized budesonide and levosalbutamol (group A) versus commonly used ipratropium bromide and levosalbutamol (group B) in children (5-11 years) with mild-moderate exacerbation of asthma.

Methods: Was an observational comparative study involving 2 treatment groups of children in age group of (5-11) years, with mild-moderate exacerbation of asthma assessed by peak expiratory flow rate (PEFR) and pulmonary score (PS).

Results: Of 160 children analyzed, post nebulization mean predicted PEFR improved in both of the study groups, and the mean PS decreased in both the groups post nebulization which was statistically significant (p<0.001). But when comparing between the groups, the mean percentage of improvement in predicted PEFR and PS were almost similar.

Conclusions: Even though, both the groups gave the same end result the group in which budesonide was used had a higher recovery time with the least number of nebulization.

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Author Biographies

Jose P. Cyril, Department of Pediatrics, Dr Somervell Memorial CSI Medical College, Karakonam, Trivandrum, Kerala, India

Associate Professor in Paediatrics

Dr.S.M.C.S.I Medical College, Karakonam,Trivandrum, Kerala

Baburaj S., Department of Pediatrics, Dr Somervell Memorial CSI Medical College, Karakonam, Trivandrum, Kerala, India

Professor in Paediatrics

Dr.S.M.C.S.I Medical College, Karakonam,Trivandrum, Kerala

Priya S. Nair, Department of Pediatrics, Dr Somervell Memorial CSI Medical College, Karakonam, Trivandrum, Kerala, India

Consultant Paediatricians

 People's Hospital, Pathanamthitta, Kerala

Tinu A. Kuruvilla, Department of Pediatrics, Dr Somervell Memorial CSI Medical College, Karakonam, Trivandrum, Kerala, India

Junior Resident

Department of Paediatrics

Dr.S.M.C.S.I Medical College and Hospital

Karakonam, Trivandrum, Kerala

Bobby C., Department of Pediatrics, Dr Somervell Memorial CSI Medical College, Karakonam, Trivandrum, Kerala, India

Junior Resident

Department of Paediatrics

Dr.S.M.C.S.I Medical College and Hospital

Karakonam, Trivandrum, Kerala

Lini B. Das, Department of Pediatrics, Dr Somervell Memorial CSI Medical College, Karakonam, Trivandrum, Kerala, India

Junior Resident

Department of Paediatrics

Dr.S.M.C.S.I Medical College and Hospital

Karakonam, Trivandrum, Kerala

References

Andrew HL, Covar RA, Spahn JD, Leung DYM. Childhood asthma. In: Kleigman RM, Jenson HB Behrman RE, Stanton BF. editors Nelson textbook of pediatrics. India: Elsevier; 2015;1(19):780-801.

Expert panel report 3 (Guidelines for diagnosis and management of asthma, coordinated by National heart, lung and blood institute (NHLBI) of national institute of health)-report 2007 Component Introduction. 2007.

Nuhoglu Y, Atas E, Nuhoglu C, Iscan M, Ozcay S. Acute effect of nebulised budesonide in children J Invest Allergol Clin Immunol. 2005;15(3);197-200.

Andrew HL, Covar RA, Spahn JD, Leung DYM. Childhood asthma. In: Kleigman RM, Jenson HB Behrman RE, Stanton BF. editors Nelson textbook of pediatrics. India: Elsevier; 2015;1(19):780-801.

Smith SR, Baty JD, Hodge B. Validation of pulmonary score: An asthma severity score for children. Academic emergency med. 2002;9(2):99-104.

National asthma education and prevention programme (NAEPP), EPR-3 Guidelines for diagnosis and management of asthma, Clinical practice guideline. NIHpub no.08-4051, Aug 2007. www.nhlbi.gov/guidelines/asthma/asthgdln.htm. Accessed on 08/05/2020.

Szefler SJ. Review of budesonide inhalation suspension in the treatment of paediatric asthma. Pharmacotherap. 2001;21(2):195-206.

National Asthma Education and Prevention Programme. EPR: Guidelines for diagnosis and management of asthma-2002. J Allergy Clin Immunol. 2002;110(5):S141-219.

Paramesh H. Normal peak expiratory flow rate in urban and rural children. Indian J Paediatrics. 2003;70(5):375-7.

Kerem E, Tibshirani R, Canny G, Bentur L, Reisman J, Schuh S et al. Predicting the need for hospitalization in children with acute asthma. Chest. 1990;98(6):1355-61.

Fischl MA, Pitchenik A, Gardner LB. An index predicting relapses and need for hospitalization in patients with acute bronchial asthma. N Engl J Med. 1981;305(14):783-9.

Singhi S, Banerjee S, Nanjundaswamy H. Inhaled budesonide in acute asthma J Paediatr child Health. 1999;35(5):483-7.

Volovitz B, Soferman R, Blau H, Nussinovitch M, Varsano I. Rapid induction of clinical response with a short-term high- dose starting schedule of budesonide nebulizing suspension in young children with recurrent wheezing episodes. J allergy clinimmunol. 1998:10:464-9.

Rodrigo GJ, Rodrigo C. First-line therapy for adult patients with acute asthma receiving a multiple-dose protocol of ipratropium bromide plus albuterol in the emergency department. Am J Respir Crit Care Med. 2000;161(6):1862-8.

Chakraborti A, Lodha R, Pandey RM, Kabra SK. Randomised controlled trial of ipratropium bromide and salbutamol versus salbutamol alone in children with acute exacerbation of asthma. Indian J Pediatr. 2006;73(11):979-83.

Qureshi F, Pestian J, Davis P, Zaritsky A. Effect of nebulized ipratropium bromide on the hospitalization rates of children with asthma. Engl J med. 1998;339(15):1030-5.

Goggin N, Mecarthur C, Parkin PC. Randomised trial of the addition of ipratropium bromide to albuterol and corticosteroid therapy in children hospitalized because of an acute asthma exacerbation. Arch Pediatradolesc Med. 2001;155(12):1329-34.

Milani GK, Rosário Filho NA, Riedi CA, Figueiredo BC. Nebulized budesonide to treat acute asthma in children. J Pediatr. 2004;80(2):106-12.

Sano F, Cortez GK, Sole D, Naspitz Ck. Nebulized budesonide in the treatment of acute episode of wheeze in infants. J Allergy Clin Immunol. 1998;101:S9.

Plotnick LH, Ducherme FM. Should inhaled anti cholinergicsbe added to beta 2 agonist for treating acute childhood and adolescent asthma-A systemic review. BMJ. 1998:317:971-7.

Nuhoglu Y, Bahceciler NN, Barlan IB, Müjdat Başaran M. The effectiveness of high-dose inhaled budesonide therapy in the treatment of acute asthma exacerberation in children. Ann Allergy Asthma Immunol. 2001;86 (3):318-22.

Vathenen AS, Knox AJ, Wisniewski A, Tattersfield AE. Time course of change in bronchial reactivity with an inhaled corticosteroid in asthma. Am Rev Respir Dis. 1991;143(6):1317-21.

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Published

2020-12-23

How to Cite

Cyril, J. P., S., B., Nair, P. S., Kuruvilla, T. A., C., B., & Das, L. B. (2020). A comparative study on the effect of nebulized budesonide and levosalbutamol versus ipratropium bromide and levosalbutamol in the management of acute asthma in children aged 5-11 years. International Journal of Contemporary Pediatrics, 8(1), 65–69. https://doi.org/10.18203/2349-3291.ijcp20205507

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Original Research Articles