Inhaled salbutamol for wheezy infants: a randomised controlled trial.
BACKGROUND
Salbutamol is frequently used as a bronchodilator for infants who wheeze. Many single dose studies have questioned its effectiveness.


OBJECTIVE
To investigate the response of wheezy infants to salbutamol over an extended time period in order to elucidate either symptomatic relief or a protective effect.


METHODS
Eighty infants under 1 year, with persistent or recurrent wheeze and a personal or family history of atopy, were recruited to a randomised, double blind, cross over, placebo controlled trial. Salbutamol (200 microg three times daily) or placebo were administered regularly over two consecutive treatment periods of four weeks via a spacer and mask. Symptoms of wheeze and cough were recorded in a diary. At the end of the study pulmonary function tests were performed before and after salbutamol (400 microg).


RESULTS
Forty eight infants completed the diary study; 40 infants underwent pulmonary function testing. No difference in mean daily symptom score was observed between the salbutamol and placebo periods. There was no difference in the number of symptom free days. Compliance and forced expiratory flows remained unchanged and resistance increased following salbutamol. There was no relation between the response measured by symptom score or pulmonary function in individual patients.


CONCLUSIONS
In wheezy infants with an atopic background, there was no significant beneficial effect of salbutamol on either clinical symptoms or pulmonary function. Clinical effects could not be predicted from pulmonary function tests. Salbutamol cannot be recommended as the bronchodilator of choice in this age group.
Chavasse
R J
RJ
The Royal Alexandra Hospital for Sick Children, Dyke Road, Brighton BN1 3JN, UK. rah@mistral.co.uk
Bastian-Lee
Y
Y
Richter
H
H
Hilliard
T
T
Seddon
P
P
D000280:Administration, Inhalation; D000420:Albuterol / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005540:Forced Expiratory Flow Rates / Q000187:drug effects; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000503:physiopathology / Q000517:prevention & control*; D007223:Infant; D007231:Infant, Newborn; D008170:Lung Compliance / Q000187:drug effects; D008499:Medical Records; D012135:Respiratory Sounds
D001993:Bronchodilator Agents; D000420:Albuterol