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Budesonide reduces hospital admission rates in preschool children with acute wheezing
Author(s) -
Razi Cem Hasan,
Cörüt Nazlı,
Andıran Nesibe
Publication year - 2017
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23667
Subject(s) - medicine , budesonide , placebo , salbutamol , anesthesia , corticosteroid , asthma , methylprednisolone , acute severe asthma , randomized controlled trial , pediatrics , respiratory disease , lung , alternative medicine , pathology
Summary Background The object of this study was to determine whether high doses of inhaled budesonide provide additional benefits to a standardized treatment regimen that includes systemic steroids and salbutamol in preschool patients presented to the emergency department (ED) with acute wheezing attacks. Methods This randomized, double‐blind, placebo‐controlled, parallel group trial was conducted in children, 6 months–6 years with moderate or severe acute wheezing epizode, as determined based on a pulmonary index score (PIS) of 7–13 points. We compared the addition of budesonide 3 mg versus placebo to standard acute asthma treatment, which included salbutamol and a single 1 mg/kg dose of methylprednisolone given at the beginning of therapy. The primary outcome was differences in hospitalization rates within 4 hr. Secondary outcome was difference in median PIS between treatment groups at 2 hr. Results One hundred patients were enrolled. Cumulative hospitalization rate at 120, 180, and 240 min were 0.72, 0.62, and 0.58 in placebo group; and 0.44, 0.30, and 0.24 in budesonide group. Discharged rate in budesonide group was significantly higher than the placebo group (log‐rank = 12.407 ve P < 0.001). Expected mean discharged times were 200.4 (95%CI = 185.3–215.5) min in placebo group and 164.4 (95%CI = 149.4–179.4) min in budesonide group. Median (25–75%) PIS at the 120th min was significantly lower in budesonide group than the placebo group (5 [4–8] vs. 8 [5–9] respectively, P = 0.006). Conclusions The addition of budesonide nebulization may decrease the admission rate of preschool children who have moderate to severe acute wheezing epizodes. Pediatr Pulmonol. 2017;52:720–728. © 2017 Wiley Periodicals, Inc.