This study was done to determine the effects and outcome of inhaled
budesonide in addition to standard management of
asthma exacerbations in pediatric age groups. A randomized, double-blind, placebo controlled trial was done in a tertiary care urban hospital. Sixty six children aged 5 to 15 years with moderate to severe
asthma exacerbations were eligible. All patients received a single dose of
prednisolone 1mg/kg orally as first dose of systemic
corticosteroids and then
salbutamol (0.15mg/kg) and
ipratropium bromide (500mcg) was nebulized every 20 minutes for 3 doses and then hourly for 2 hours as a part of standard treatment of
asthma exacerbations. The intervention was 2mg (4mL) of
budesonide or 4mL of
normal saline which was nebulized immediately after the 1st dose of nebulized
salbutamol and
ipratropium bromide. The baseline characteristics of the
budesonide group (n=33) and placebo group (n=33) were similar, but at 1 hour, 2 hour and 3 hour PEFR, respiratory rate, pulse rate, SaO2 and
asthma score were significantly improved in the
budesonide group compared to placebo group (p<0.01). The positive immediate effect of nebulized
budesonide added to standard treatment of
asthma exacerbations is an encouraging finding for further investigations of its routine use in the treatment of
asthma exacerbations in children.