PREDNISOLONE AND SALBUTAMOL IN THE HOSPITAL TREATMENT OF ACUTE ASTHMA

The use of oral prednisolone (2 mg/kg) to treat children admitted to h ospital with acute asthma was assessed in a placebo controlled study. Children were further randomised to receive either 0.15 mg/kg salbutam ol every 30 minutes for the first three hours of admission, or 5 mg sa lbutamol every one to four hours as needed. Treatment was double blind and the assessor was unaware of the nebuliser regimen given. Children were examined before and after treatment with salbutamol on arrival a nd reassessed four hours after admission. Seventy children completed t he study. Seventeen (46%) of 37 children receiving prednisolone and si x (9%) of 33 receiving placebo were fit for discharge after four hours of treatment. There was no significant difference between the two neb uliser regimens. Clinical parameters indicative of asthma severity wer e improved in all groups. Between group comparisons at reassessment sh owed higher peak flows in those receiving prednisolone and nebulisers every 30 minutes but differences were not significant for other parame ters. Objective parameters indicating steroid efficacy over placebo we re minimal. Despite this, those receiving prednisolone were more readi ly identifiable as being fit for discharge within four hours of treatm ent.