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. 1994 Mar;70(3):170–173. doi: 10.1136/adc.70.3.170

Prednisolone and salbutamol in the hospital treatment of acute asthma.

G J Connett 1, C Warde 1, E Wooler 1, W Lenney 1
PMCID: PMC1029734  PMID: 8135557

Abstract

The use of oral prednisolone (2 mg/kg) to treat children admitted to hospital with acute asthma was assessed in a placebo controlled study. Children were further randomised to receive either 0.15 mg/kg salbutamol every 30 minutes for the first three hours of admission, or 5 mg salbutamol every one to four hours as needed. Treatment was double blind and the assessor was unaware of the nebuliser regimen given. Children were examined before and after treatment with salbutamol on arrival and reassessed four hours after admission. Seventy children completed the study. Seventeen (46%) of 37 children receiving prednisolone and six (9%) of 33 receiving placebo were fit for discharge after four hours of treatment. There was no significant difference between the two nebuliser regimens. Clinical parameters indicative of asthma severity were improved in all groups. Between group comparisons at reassessment showed higher peak flows in those receiving prednisolone and nebulisers every 30 minutes but differences were not significant for other parameters. Objective parameters indicating steroid efficacy over placebo were minimal. Despite this, those receiving prednisolone were more readily identifiable as being fit for discharge within four hours of treatment.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Chapman K. R., Verbeek P. R., White J. G., Rebuck A. S. Effect of a short course of prednisone in the prevention of early relapse after the emergency room treatment of acute asthma. N Engl J Med. 1991 Mar 21;324(12):788–794. doi: 10.1056/NEJM199103213241202. [DOI] [PubMed] [Google Scholar]
  2. Connett G. J., Lenney W. Use of pulse oximetry in the hospital management of acute asthma in childhood. Pediatr Pulmonol. 1993 Jun;15(6):345–349. doi: 10.1002/ppul.1950150606. [DOI] [PubMed] [Google Scholar]
  3. Connett G. J., Warde C., Wooler E., Lenney W. Audit strategies to reduce hospital admissions for acute asthma. Arch Dis Child. 1993 Aug;69(2):202–205. doi: 10.1136/adc.69.2.202. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Deshpande A., McKenzie S. A. Short course of steroids in home treatment of children with acute asthma. Br Med J (Clin Res Ed) 1986 Jul 19;293(6540):169–171. doi: 10.1136/bmj.293.6540.169. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fanta C. H., Rossing T. H., McFadden E. R., Jr Glucocorticoids in acute asthma. A critical controlled trial. Am J Med. 1983 May;74(5):845–851. doi: 10.1016/0002-9343(83)91076-8. [DOI] [PubMed] [Google Scholar]
  6. Fiel S. B., Swartz M. A., Glanz K., Francis M. E. Efficacy of short-term corticosteroid therapy in outpatient treatment of acute bronchial asthma. Am J Med. 1983 Aug;75(2):259–262. doi: 10.1016/0002-9343(83)91202-0. [DOI] [PubMed] [Google Scholar]
  7. Gleeson J. G., Loftus B. G., Price J. F. Placebo controlled trial of systemic corticosteroids in acute childhood asthma. Acta Paediatr Scand. 1990 Nov;79(11):1052–1058. doi: 10.1111/j.1651-2227.1990.tb11382.x. [DOI] [PubMed] [Google Scholar]
  8. Harris J. B., Weinberger M. M., Nassif E., Smith G., Milavetz G., Stillerman A. Early intervention with short courses of prednisone to prevent progression of asthma in ambulatory patients incompletely responsive to bronchodilators. J Pediatr. 1987 Apr;110(4):627–633. doi: 10.1016/s0022-3476(87)80567-x. [DOI] [PubMed] [Google Scholar]
  9. Kattan M., Gurwitz D., Levison H. Corticosteroids in status asthmaticus. J Pediatr. 1980 Mar;96(3 Pt 2):596–599. doi: 10.1016/s0022-3476(80)80872-9. [DOI] [PubMed] [Google Scholar]
  10. Littenberg B., Gluck E. H. A controlled trial of methylprednisolone in the emergency treatment of acute asthma. N Engl J Med. 1986 Jan 16;314(3):150–152. doi: 10.1056/NEJM198601163140304. [DOI] [PubMed] [Google Scholar]
  11. McFadden E. R., Jr, Kiser R., deGroot W. J., Holmes B., Kiker R., Viser G. A controlled study of the effects of single doses of hydrocortisone on the resolution of acute attacks of asthma. Am J Med. 1976 Jan;60(1):52–59. doi: 10.1016/0002-9343(76)90533-7. [DOI] [PubMed] [Google Scholar]
  12. Pierson W. E., Bierman C. W., Kelley V. C. A double-blind trial of corticosteroid therapy in status asthmaticus. Pediatrics. 1974 Sep;54(3):282–288. [PubMed] [Google Scholar]
  13. Robertson C. F., Smith F., Beck R., Levison H. Response to frequent low doses of nebulized salbutamol in acute asthma. J Pediatr. 1985 Apr;106(4):672–674. doi: 10.1016/s0022-3476(85)80101-3. [DOI] [PubMed] [Google Scholar]
  14. Schuh S., Parkin P., Rajan A., Canny G., Healy R., Rieder M., Tan Y. K., Levison H., Soldin S. J. High-versus low-dose, frequently administered, nebulized albuterol in children with severe, acute asthma. Pediatrics. 1989 Apr;83(4):513–518. [PubMed] [Google Scholar]
  15. Schuh S., Reider M. J., Canny G., Pender E., Forbes T., Tan Y. K., Bailey D., Levison H. Nebulized albuterol in acute childhood asthma: comparison of two doses. Pediatrics. 1990 Oct;86(4):509–513. [PubMed] [Google Scholar]
  16. Shapiro G. G., Furukawa C. T., Pierson W. E., Gardinier R., Bierman C. W. Double-blind evaluation of methylprednisolone versus placebo for acute asthma episodes. Pediatrics. 1983 Apr;71(4):510–514. [PubMed] [Google Scholar]
  17. Stein L. M., Cole R. P. Early administration of corticosteroids in emergency room treatment of acute asthma. Ann Intern Med. 1990 Jun 1;112(11):822–827. doi: 10.7326/0003-4819-112-11-822. [DOI] [PubMed] [Google Scholar]
  18. Storr J., Barrell E., Barry W., Lenney W., Hatcher G. Effect of a single oral dose of prednisolone in acute childhood asthma. Lancet. 1987 Apr 18;1(8538):879–882. doi: 10.1016/s0140-6736(87)92857-1. [DOI] [PubMed] [Google Scholar]
  19. Tal A., Levy N., Bearman J. E. Methylprednisolone therapy for acute asthma in infants and toddlers: a controlled clinical trial. Pediatrics. 1990 Sep;86(3):350–356. [PubMed] [Google Scholar]
  20. Younger R. E., Gerber P. S., Herrod H. G., Cohen R. M., Crawford L. V. Intravenous methylprednisolone efficacy in status asthmaticus of childhood. Pediatrics. 1987 Aug;80(2):225–230. [PubMed] [Google Scholar]

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