THEOPHYLLINE TARGET CONCENTRATION IN SEVERE AIRWAYS OBSTRUCTION - 10 OR 20 MG L - A RANDOMIZED CONCENTRATION-CONTROLLED TRIAL/

The optimal serum concentration of theophylline for the management of acute airways obstruction was evaluated by comparing the response to t arget concentrations at the extremes of the usual therapeutic range. 1 74 patients requiring intravenous theophylline were randomly assigned to a target concentration of 10 or 20 mg/L. Control of theophylline do sage using measured theophylline concentrations and evaluation of effi cacy and toxicity was performed under double-blind conditions. 87 pati ents (50%) required hospital admission. Of these, 54 patients (62%) we re followed throughout their hospital admission and reviewed at an out patient clinic approximately 1 week after discharge. The duration of h ospital stay, and rate and extent of improvement in peak expiratory fl ow rate were not different between the groups. There was significantly more toxicity in the 20 mg/L group. The initial target concentration for theophylline in the management of acute airway obstruction should be 10 mg/L under circumstances where concentration is used to control theophylline dosages.