Efficacy of intravenously administered theophylline in children hospitalized with severe asthma.
OBJECTIVE
To determine whether intravenously administered theophylline, when added to frequently nebulized albuterol and intravenously administered methylprednisolone, benefits children hospitalized with severe asthma.


METHODS
Prospective, randomized, placebo-controlled, parallel-group, double-blind study.


METHODS
Inpatient pediatric service at a tertiary-care teaching hospital.


METHODS
Twenty-one children 5 to 18 years of age.


METHODS
All patients received 2.5 to 5.0 mg of nebulized albuterol every 20 minutes to every 6 hours, intravenously administered methylprednisolone (1 mg/kg every 6 hours), and either intravenously administered theophylline (as aminophylline) or placebo for 36 hours. Serum theophylline concentrations were maintained between 55 and 110 mumol/L (between 10 and 20 micrograms/ml) by adjusting loading doses and continuous infusion rates.


RESULTS
Forced expired volume in 1 second (FEV1) and clinical score were measured at 0, 1, 3, 6, 12, 24, and 36 hours after the start of each individual study. The total number of nebulizations, total albuterol dosage, adverse effects, and duration of hospital stay were recorded. Twelve children received theophylline and nine received placebo. The two groups did not differ significantly in age, sex, or baseline FEV1. In both groups, clinical score significantly improved from baseline by 12 hours, and FEV1 by 24 hours (p < 0.05). There were no significant differences between the groups in FEV1 or clinical score at any of the measured time points. There were no significant differences in rate of improvement in FEV1, total number of nebulizations, total albuterol dosage, or duration of hospital stay. Adverse effects were mild and infrequent and did not differ significantly between the two groups.


CONCLUSIONS
Theophylline, at therapeutic concentrations, did not additionally benefit children hospitalized with severe asthma who were being treated frequently with nebulized albuterol and with methylprednisolone intravenously.
Carter
E
E
Department of Pediatrics, University of Florida College of Medicine, Gainesville.
Cruz
M
M
Chesrown
S
S
Shieh
G
G
Reilly
K
K
Hendeles
L
L
D000280:Administration, Inhalation; D000293:Adolescent; D000420:Albuterol / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D007902:Length of Stay; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D011446:Prospective Studies; D013147:Spirometry; D013806:Theophylline / Q000008:administration & dosage* / Q000097:blood
D013806:Theophylline; D000420:Albuterol; D008775:Methylprednisolone