In a double-blind, placebo-controlled trial, 40 infants between 6 weeks and 24 months of age who had a first episode of
wheezing and other signs and symptoms of
bronchiolitis were randomly assigned to receive either nebulized
albuterol (0.15 mg/kg/dose) or placebo (
saline solution) for two administrations 1 hour apart. The
albuterol therapy resulted in a significantly greater improvement in the accessory muscle score (decreases 0.70 vs decreases 0.30; p = 0.03), oxygen saturation (increases 0.71% vs decreases 0.47%; p = 0.01) after one dose, and in the accessory muscle score (decreases 0.86 vs decreases 0.37; p = 0.02), respiratory rate (decreases 19.6% vs decreases 8.0%; p = 0.016), and oxygen saturation (increases 0.76% vs decreases 0.79%; p = 0.015) after two doses of the
drug. The response to
therapy was similar in infants younger and those older than 6 months of age. The heart rate rose slightly more in the
albuterol group (increases 7.76 from baseline) versus the placebo group (decreases 6.79). There were no other side effects of the treatment. Of the 34 children from whom nasal specimens were obtained by swab for viral identification, 24 had positive test results (21 for respiratory syncytial virus, 1 for
parainfluenza, 1 for paramyxovirus, and 1 for
influenza A). We conclude that nebulized
albuterol constitutes a safe and effective treatment of infants with
bronchiolitis.