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Free Content Comparison of clinical outcome with oral and inhaled bronchodilators in the management of wheezy children aged 1–59 months in the community: a randomised trial in Pakistan

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BACKGROUND: Wheeze is a significant problem in children. There is a gradual trend of switching from oral to inhaled bronchodilator therapy. No randomised trials have been carried out in the community to compare the clinical outcome of two modes of therapy. If outcome with oral and inhaled bronchodilators is the same in young wheezers in developing countries, it will be easier to manage them.

METHODS: In a randomised multicentre trial, wheezy children aged 1–59 months with fast breathing and/or lower chest indrawing received oral or inhaled salbutamol at home after responding to up to three cycles of inhaled bronchodilators. They were re-assessed on days 3 and 5 for clinical outcome.

RESULTS: From May 2001 to August 2002, 780 children were enrolled; 390 each were randomised to oral and inhaled salbutamol. On day 5, 324 (83.1%) children in the oral and 328 (84.1%) in the inhaled group were completely well. There were no differences in clinical outcome of both modes of therapy.

CONCLUSIONS: The clinical outcome of children aged 1–59 months with wheeze is similar when treated with oral or inhaled salbutamol. Acute respiratory infection control programmes in developing countries should continue to use oral bronchodilators for the management of wheeze to save both time and money.
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Keywords: child; metered dose inhaler; oral salbutamol; wheezing

Document Type: Regular Paper

Affiliations: 1: The Children's Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan 2: Department of Child and Adolescent Health and Development, World Health Organization, Geneva, Switzerland 3: Children's Hospital, Lahore, Punjab, Pakistan 4: Department of Paediatrics, Rawalpindi General Hospital, Rawalpindi, Punjab, Pakistan

Publication date: 01 November 2004

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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