THE ROLE OF BRONCHODILATORS IN THE MANAGEMENT OF BRONCHIOLITIS - A CLINICAL-TRIAL

A randomized clinical trial was conducted on young children with bronc hiolitis admitted to hospital with moderate illness to determine the e fficacy of the bronchodilators Salbutamol and ipratropium bromide, eit her as a single drug or in combination, given as a nebulized solution, compared with a normal saline placebo. Eighty-nine patients, aged fro m 23 days to 11 months, were randomized into four groups, depending on administered drug or placebo, as follows: group 1-Salbutamol (n = 20) ; group 2-ipratropium bromide (n = 23); group 3-combined Salbutamol an d Ipratropium bromide (n = 24); group 4-normal saline (n = 22). The gr oups were identical with respect to age, sex, family history of atopy, respiratory syncytial virus (RSV) positivity and enrolment score. The y were scored using the clinical parameters of wheezing, retractions a nd respiratory rate at enrolment, at 30 and 60 minutes after the first nebulization, and after 60 minutes following completion of subsequent nebulization at 6, 12, 24 and 36 hours. We did not find any significa nt difference in the rate of improvement and the final score (p = 0.49 ) in the four groups. The same finding was also noted in children aged more than 3 months (p = 0.35) and in those positive for RSV infection (p = 0.18). The lengths of hospitalization in the four groups were al so similar (p = 0.79). It is concluded that there is no role for the n ebulized bronchodilators Salbutamol and Ipratropium bromide, either as a single agent or in combination, compared with normal saline placebo in treating young children in hospital with bronchiolitis.