title: High-dose nebulized budesonide is effective for mild asthma exacerbations in children under 3 years of age.
abstract: Background.High-dose inhaled steroid therapy has been shown to be effective in children and adults with asthma exacerbations. However, few reports are available regarding its efficacy for asthma exacerbations in younger children.Objective.In this study, we administered high-dose nebulized budesonide therapy for mild asthma exacerbations in children < 3 years of age and compared its efficacy and safety with systemic steroid therapy.Methods.This study included children < 3 years old with mild asthma exacerbations. Patients were randomly assigned to two groups: the BIS group was given 1 mg of nebulized budesonide twice daily, and the PSL group received prednisolone 0.5 mg/kg iv three times daily. Days to disappearance of wheezing, days of steroid use, days of oxygen use, serum cortisol level, and incidence of adverse events during treatment were compared between the groups.Result.Wheezing disappeared after an average of five days, and steroids were administered for an average of five days in both groups, with no significant difference in days of oxygen use. Serum cortisol levels at initiation and during the course of treatment remained unchanged in the BIS group, and were decreased in the PSL group; however, the decrease in the latter group was not pathologic.Conclusion.For children < 3 years old with mild asthma exacerbations, high-dose nebulized budesonide therapy is equally as effective as systemic steroid therapy.
authors.affiliation: Department of Pediatrics, Haga Red Cross Hospital, 2461 Daimachi Mouka, Tochigi, 321-4306, Japan. Phone: +81 285 84 3332 Fax: +81 285 82 2195 E-mail: mari.saito@haga.jrc.or.jp.
authors.forename: M
authors.initials: M
authors.lastname: Saito
authors.affiliation: Department of Pediatrics, Haga Red Cross Hospital, 2461 Daimachi Mouka, Tochigi, 321-4306, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kikuchi
authors.affiliation: Department of Surgery, Jichi Medical University, 3331-1 Yakushiji, Simotsuke, Tochigi, 320-0498, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Kawarai Lefor
authors.affiliation: Department of Pediatrics, Haga Red Cross Hospital, 2461 Daimachi Mouka, Tochigi, 321-4306, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hoshina
mesh_terms: D001249:Asthma / Q000188:drug therapy*; D019819:Budesonide / Q000008:administration & dosage* / Q000009:adverse effects; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009330:Nebulizers and Vaporizers
chemical_list: D019819:Budesonide; D006854:Hydrocortisone
keywords: Asthma; budesonide; exacerbation; infants; steroid