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. 1992 Mar;67(3):285–288. doi: 10.1136/adc.67.3.285

Inhaled budesonide for chronic wheezing under 18 months of age.

V Noble 1, N R Ruggins 1, M L Everard 1, A D Milner 1
PMCID: PMC1793643  PMID: 1575550

Abstract

The role of budesonide in controlling chest symptoms in infants was assessed. It was administered from a metered dose inhaler into a large volume spacer (Nebuhaler) with attached Laerdal mask. Twenty nine infants were recruited into a double blind crossover trial. Five defaulted. The remaining 24 (mean age 11 months) were assessed for the tolerance of the device, adverse effects, treatment failures, parental opinion, and daily symptom and treatment records. Twenty tolerated the modified Nebuhaler. One developed meningitis on placebo. Two experienced exacerbations on placebo. Eleven of 18 parents whose children completed the maximum treatment preferred budesonide to placebo and one preferred placebo. Mean symptom scores on budesonide were better than on placebo for the 15 children with complete symptom records. Fewer bronchodilator doses were used while taking budesonide. Our findings indicate that budesonide given in this way is an effective treatment for infants who may need prophylaxis for their wheezing.

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Selected References

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  1. Bisgaard H., Munck S. L., Nielsen J. P., Petersen W., Ohlsson S. V. Inhaled budesonide for treatment of recurrent wheezing in early childhood. Lancet. 1990 Sep 15;336(8716):649–651. doi: 10.1016/0140-6736(90)92147-a. [DOI] [PubMed] [Google Scholar]
  2. Bisgaard H., Ohlsson S. PEP-spacer: an adaptation for administration of MDI to infants. Allergy. 1989 Jul;44(5):363–364. doi: 10.1111/j.1398-9995.1989.tb00459.x. [DOI] [PubMed] [Google Scholar]
  3. Brooks L. J., Cropp G. J. Theophylline therapy in bronchiolitis. A retrospective study. Am J Dis Child. 1981 Oct;135(10):934–936. doi: 10.1001/archpedi.1981.02130340040014. [DOI] [PubMed] [Google Scholar]
  4. Carlsen K. H., Leegaard J., Larsen S., Orstavik I. Nebulised beclomethasone dipropionate in recurrent obstructive episodes after acute bronchiolitis. Arch Dis Child. 1988 Dec;63(12):1428–1433. doi: 10.1136/adc.63.12.1428. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Freigang B. Long-term follow-up of infants and children treated with beclomethasone aerosol by a special inhalation device. Ann Allergy. 1980 Jul;45(1):13–17. [PubMed] [Google Scholar]
  6. Freigang B. New method of beclomethasone aerosol administration to children under 4 years of age. Can Med Assoc J. 1977 Dec 3;117(11):1308–1309. [PMC free article] [PubMed] [Google Scholar]
  7. Geller-Bernstein C., Levin S. Nebulised sodium cromoglycate in the treatment of wheezy bronchitis in infants and young children. Respiration. 1982;43(4):294–298. doi: 10.1159/000194497. [DOI] [PubMed] [Google Scholar]
  8. Gleeson J. G., Price J. F. Controlled trial of budesonide given by the nebuhaler in preschool children with asthma. BMJ. 1988 Jul 16;297(6642):163–166. doi: 10.1136/bmj.297.6642.163. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Godfrey S., König P. Treatment of childhood asthma for 13 months and longer with beclomethasone dipropionate aerosol. Arch Dis Child. 1974 Aug;49(8):591–596. doi: 10.1136/adc.49.8.591. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Henry R. L., Hiller E. J., Milner A. D., Hodges I. G., Stokes G. M. Nebulised ipratropium bromide and sodium cromoglycate in the first two years of life. Arch Dis Child. 1984 Jan;59(1):54–57. doi: 10.1136/adc.59.1.54. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hodges I. G., Groggins R. C., Milner A. D., Stokes G. M. Bronchodilator effect of inhaled ipratropium bromide in wheezy toddlers. Arch Dis Child. 1981 Sep;56(9):729–732. doi: 10.1136/adc.56.9.729. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Lenney W., Milner A. D. At what age do bronchodilator drugs work? Arch Dis Child. 1978 Jul;53(7):532–535. doi: 10.1136/adc.53.7.532. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. McMillan J. A., Oski F. A. Pediatrics. JAMA. 1991 Jun 19;265(23):3156–3158. [PubMed] [Google Scholar]
  14. Mundy A. R. Artificial urinary sphincters. Arch Dis Child. 1986 Jan;61(1):1–3. doi: 10.1136/adc.61.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. O'Callaghan C., Milner A. D., Swarbrick A. Paradoxical deterioration in lung function after nebulised salbutamol in wheezy infants. Lancet. 1986 Dec 20;2(8521-22):1424–1425. doi: 10.1016/s0140-6736(86)92735-2. [DOI] [PubMed] [Google Scholar]
  16. O'Callaghan C., Milner A. D., Swarbrick A. Spacer device with face mask attachment for giving bronchodilators to infants with asthma. BMJ. 1989 Jan 21;298(6667):160–161. doi: 10.1136/bmj.298.6667.160. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. O'Callaghan C. Particle size of beclomethasone dipropionate produced by two nebulisers and two spacing devices. Thorax. 1990 Feb;45(2):109–111. doi: 10.1136/thx.45.2.109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Prendiville A., Green S., Silverman M. Airway responsiveness in wheezy infants: evidence for functional beta adrenergic receptors. Thorax. 1987 Feb;42(2):100–104. doi: 10.1136/thx.42.2.100. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Prendiville A., Green S., Silverman M. Ipratropium bromide and airways function in wheezy infants. Arch Dis Child. 1987 Apr;62(4):397–400. doi: 10.1136/adc.62.4.397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Radford M. Effect of salbutamol in infants with wheezy bronchitis. Arch Dis Child. 1975 Jul;50(7):535–538. doi: 10.1136/adc.50.7.535. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Rahmathullah L., Underwood B. A., Thulasiraj R. D., Milton R. C., Ramaswamy K., Rahmathullah R., Babu G. Reduced mortality among children in southern India receiving a small weekly dose of vitamin A. N Engl J Med. 1990 Oct 4;323(14):929–935. doi: 10.1056/NEJM199010043231401. [DOI] [PubMed] [Google Scholar]
  22. Silverman M. Bronchodilators for wheezy infants? Arch Dis Child. 1984 Jan;59(1):84–87. doi: 10.1136/adc.59.1.84. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Sommer A., Tarwotjo I., Djunaedi E., West K. P., Jr, Loeden A. A., Tilden R., Mele L. Impact of vitamin A supplementation on childhood mortality. A randomised controlled community trial. Lancet. 1986 May 24;1(8491):1169–1173. doi: 10.1016/s0140-6736(86)91157-8. [DOI] [PubMed] [Google Scholar]
  24. Tal A., Bavilski C., Yohai D., Bearman J. E., Gorodischer R., Moses S. W. Dexamethasone and salbutamol in the treatment of acute wheezing in infants. Pediatrics. 1983 Jan;71(1):13–18. [PubMed] [Google Scholar]
  25. Van Bever H. P., Schuddinck L., Wojciechowski M., Stevens W. J. Aerosolized budesonide in asthmatic infants: a double blind study. Pediatr Pulmonol. 1990;9(3):177–180. doi: 10.1002/ppul.1950090310. [DOI] [PubMed] [Google Scholar]
  26. Vijayaraghavan K., Radhaiah G., Prakasam B. S., Sarma K. V., Reddy V. Effect of massive dose vitamin A on morbidity and mortality in Indian children. Lancet. 1990 Dec 1;336(8727):1342–1345. doi: 10.1016/0140-6736(90)92895-o. [DOI] [PubMed] [Google Scholar]
  27. Webb M. S., Henry R. L., Milner A. D. Oral corticosteroids for wheezing attacks under 18 months. Arch Dis Child. 1986 Jan;61(1):15–19. doi: 10.1136/adc.61.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. West K. P., Jr, Pokhrel R. P., Katz J., LeClerq S. C., Khatry S. K., Shrestha S. R., Pradhan E. K., Tielsch J. M., Pandey M. R., Sommer A. Efficacy of vitamin A in reducing preschool child mortality in Nepal. Lancet. 1991 Jul 13;338(8759):67–71. doi: 10.1016/0140-6736(91)90070-6. [DOI] [PubMed] [Google Scholar]

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