[Decreased theophylline clearance in children with acute asthma with concurrent febrile respiratory infection].
Elevated serum levels of theophylline, a first-line anti-asthma drug, are sometimes associated with febrile respiratory infection (FRI). Although it seems to be wellknown, conflicting reports still appear in journals. We studied retrospectively theophylline clearance (th-cl) in 74 episodes of acute asthma (44 with and 30 without FRI, in patients aged 12-mos.-13-yrs.) and tried to reveal the effect of fever or pathogens on th-cl. Th-cl was estimated by a single sample technique during intravenous drip infusion of aminophylline. The results were as follows: 1) Forty four episodes with FRI included 20 viral, 10 bacterial and 2 Mycoplasma pneumoniae infections (Table 2). 2) Th-cl in 44 episodes with FRI was significantly lower than in 30 without FRI (p < 0.001). 3) Decreased tendency of th-cl in episodes with viral infection was observed, but statistically it was not significant (p < 0.1). However, the differences of th-cl among 9 pair-cases with and without viral infection were quite clear (p < 0.01). 4) Th-cl in episodes with 10 bacterial and 2 Mycoplasma infections was reduced significantly (p < 0.01). 5) There was no difference in th-cl between episodes with viral, and bacterial or Mycoplasma infections (p < 0.1). As a result, it is suggested that fever, regardless of its origin, may decrease th-cl in acute asthma with FRI.
Toba
T
T
Department of Pediatrics, Chiba Municipal Kaihin Hospital.
Kurosaki
T
T
Ohta
F
F
Tamai
K
K
Ikegami
H
H
Saitoh
Y
Y
Matsuka
Y
Y
Makino
K
K
Asai
T
T
D000208:Acute Disease; D000293:Adolescent; D000628:Aminophylline / Q000008:administration & dosage; D001249:Asthma / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005334:Fever / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D008657:Metabolic Clearance Rate; D012141:Respiratory Tract Infections / Q000150:complications* / Q000188:drug therapy; D012189:Retrospective Studies; D013806:Theophylline / Q000008:administration & dosage / Q000493:pharmacokinetics*
D000628:Aminophylline; D013806:Theophylline