title: Efficacy of nebulised budesonide versus oral prednisolone in acute severe asthma.
abstract: OBJECTIVE
  To compare the efficacy of nebulised budesonide with that of oral prednisone in the treatment of acute severe asthma in children.
  
  
  METHODS
  Children aged 5-12 y with acute exacerbation of bronchial asthma were included. The study (budesonide) group received budesonide respirator solution (800 μg) at intervals of 20 min and a single dose of placebo tablets. The control (prednisolone) group received placebo solution at intervals of 20 min and a single dose of oral prednisolone (2 mg/kg). Both groups received three doses of nebulised salbutamol (0.15 mg/kg). Heart rate, respiratory rate, oxygen saturation, PEFR (Peak Expiratory Flow Rate) and fitness for discharge were assessed.
  
  
  RESULTS
  Both groups showed a progressive decrease in tachycardia with treatment, but it was significantly greater in study group (p = 0.0002). There was significant decrease in tachypnea and improvement in oxygen saturation in both groups, but the difference between the groups (p = 0.334 and p = 0.814 respectively) was not significant. There was significant improvement in PEFR values in budesonide group (p = 0.024). Both groups showed significant improvement in clinical severity scores at the end of 2 h (p < 0.0001). Budesonide group had significantly higher proportion of patients fit for discharge at 2 h (based on clinical severity scores) (p = 0.0278).
  
  
  CONCLUSIONS
  Nebulised budesonide significantly improves PEFR levels and fitness for discharge at 2 h when compared to oral prednisolone in children between 5 and 12 y with acute severe asthma.
authors.affiliation: Department of Pediatrics, Karpaga Vinayaga Institute of Medical Sciences, Maduranthagam, Tamil Nadu, India.
authors.forename: Cuddalore Subramanian
authors.initials: CS
authors.lastname: Arulparithi
authors.forename: Thirunavukkarasu Arun
authors.initials: TA
authors.lastname: Babu
authors.forename: C
authors.initials: C
authors.lastname: Ravichandran
authors.forename: Indumathy
authors.initials: I
authors.lastname: Santhanam
authors.forename: B
authors.initials: B
authors.lastname: Sathyamurthi
authors.forename: S
authors.initials: S
authors.lastname: Parivathini
authors.forename: J
authors.initials: J
authors.lastname: Hemachitra
mesh_terms: D001993:Bronchodilator Agents / Q000008:administration & dosage; D019819:Budesonide / Q000008:administration & dosage*; D002648:Child; D004311:Double-Blind Method; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers; D010100:Oxygen / Q000032:analysis; D062072:Patient Acuity; D011239:Prednisolone / Q000008:administration & dosage*; D012129:Respiratory Function Tests / Q000379:methods; D013224:Status Asthmaticus / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D005938:Glucocorticoids; D019819:Budesonide; D011239:Prednisolone; D010100:Oxygen