Levosalbutamol via Metered-Dose Inhaler with Spacer Versus Nebulizer for Acute Exacerbation of Bronchial Asthma in Children – A Randomized Controlled Trial

Abstract

Introduction: Acute paediatric asthma can pose an emergency challenge requiring medical preparedness. Hence, it is prudent to identify the best drugdelivery option for managing acute asthma exacerbations. The objective of the study was to compare the effectiveness of metered dose inhaler with spacer (MDI-S) versus nebulizer (NEB) in delivering levosalbutamol for acute exacerbation of asthma in children.

Methods: This randomized clinical trial enrolled 58 children aged five to 15 years with mild-moderate asthma and randomly divided them into two treatment groups – Group MDI-S (N = 29) and Group NEB (N = 29). Pulmonary Index Score (PIS) along with signs and symptoms of asthma were compared between the groups before and one hour after levosalbutamol treatment. Chi square test was used to compare continuous variables and the level of significancewas set at P < 0.05.

Results: The two groups showed no significant differences in median age, age of wheezing onset, prior hospitalizations, and PIS before treatment (p > 0.05). Even one hour after treatment, they did not differ significantly in PIS and hospital admissions (P > 0.05). All children showed improvement in their asthmatic status after the therapy and none showed any worsening of their condition.

Conclusions: Metered dose inhaler with spacer is an effective and efficient alternate to the routinely used nebulizer for managing acute asthmatic episodes in children.