title: Aminophylline Dosage In Asthma Exacerbations in Children: A Systematic Review.
abstract: BACKGROUND
  Adequate asthma treatment of childhood exacerbations with IV aminophylline depends on appropriate dosage. Recommendations to aim for a target therapeutic range may be inappropriate as serum concentrations correlate poorly with clinical improvement. This review aims to evaluate the evidence for the optimum dosage strategy of intravenous aminophylline in children suffering an exacerbation of asthma.
  
  
  METHODS
  A systematic review comparing dosage regimens of intravenous aminophylline in children suffering an exacerbation of asthma. Primary outcomes were time until resolution of symptoms, mortality and need for mechanical ventilation. Secondary outcomes were date until discharge criteria are met, actual discharge and adverse effects.
  
  
  METHODS
  CENTRAL, CINAHL, MEDLINE and Web of Science. Search performed in March 2016.
  
  
  METHODS
  Studies using intravenous aminophylline in children with an acute exacerbation of asthma which reported the dosage and clinical outcomes.
  
  
  RESULTS
  14 RCTs were included. There is a poor relationship between the dosage administered to children and symptom resolution, length of stay or need for mechanical ventilation. This study is limited due to its use of indirect evidence.
  
  
  CONCLUSIONS
  The currently recommended dosage regimens may not represent the optimum safety and efficacy of intravenous aminophylline. There is a need to develop the evidence base correlating dosage with patient centered clinical outcomes, to improve prescribing practices.
authors.affiliation: Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, Merseyside, United Kingdom.
authors.forename: Lewis
authors.identifier: http://orcid.org/0000-0002-5799-9383
authors.initials: L
authors.lastname: Cooney
authors.affiliation: National Institute for Health Research Alder Hey Clinical Research Facility, Alder Hey Children's Hospital, Liverpool, Merseyside, United Kingdom.
authors.forename: Ian
authors.initials: I
authors.lastname: Sinha
authors.affiliation: Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, Merseyside, United Kingdom.|National Institute for Health Research Alder Hey Clinical Research Facility, Alder Hey Children's Hospital, Liverpool, Merseyside, United Kingdom.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hawcutt
mesh_terms: D061605:Administration, Intravenous; D000628:Aminophylline / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D004305:Dose-Response Relationship, Drug; D006801:Humans; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D000628:Aminophylline