title: Levalbuterol versus albuterol for acute asthma: a systematic review and meta-analysis.
abstract: BACKGROUND
  Conventional albuterol is a racemic mixture of (S)-albuterol and (R)-albuterol (levalbuterol). Levalbuterol is therapeutically active component of albuterol whereas (S)-albuterol is considered inert with some unwanted effects.
  
  
  OBJECTIVE
  To evaluate efficacy and safety of levalbuterol versus albuterol in acute asthma.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  Pubmed and Cochrane databases. TRIAL ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: Randomized control trials comparing levalbuterol versus albuterol for acute asthma in all age groups. DATA EXTRACTION AND RESULT SYNTHESIS: Two authors extracted data independently. Meta-analyses were performed using Review Manager Software.
  
  
  RESULTS
  Seven trials including a total of 1625 participants fulfilled the eligibility criteria. Respiratory rate, oxygen saturation, and percentage change in FEV1 and clinical asthma score were not significantly different between the groups with mean difference (95% CI) of 0.35 (-0.81, 1.51), -0.29 (-0.68, 0.10), -28.3 (-59.95, 3.33) and -1.01 (-5.30, 3.28) respectively. There were no significant differences in side effects between groups.
  
  
  CONCLUSIONS
  Data were not available for two probable eligible trials. A few assumptions and some calculated values were used for meta-analysis.
  
  
  CONCLUSIONS
  Levalbuterol was not superior to albuterol regarding efficacy and safety in subjects with acute asthma. We suggest that levalbuterol should not be used over albuterol for acute asthma.
authors.affiliation: Department of Pediatrics, Government Medical College and Hospital, Sector-32, Chandigarh 160030, India. drkanaram@gmail.com
authors.forename: Kana Ram
authors.initials: KR
authors.lastname: Jat
authors.forename: Anju
authors.initials: A
authors.lastname: Khairwa
mesh_terms: D000208:Acute Disease; D000420:Albuterol / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D013237:Stereoisomerism
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol