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Inhaled budesonide for chronic wheezing under 18 months of age
V Noble1, N R Ruggins, M L Everard
1Children's Respiratory Unit, Queen's Medical Centre, Nottingham.
Insights
Budesonide administered via a modified Nebuhaler effectively controlled wheezing symptoms in infants. This treatment reduced symptom scores and bronchodilator use, offering a potential prophylactic option for infants with recurrent chest issues.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
Background:
- Infants often experience wheezing and chest symptoms.
- Effective and safe treatment options for infant respiratory conditions are crucial.
Purpose of the Study:
- To assess the efficacy and tolerance of budesonide in controlling chest symptoms in infants.
- To evaluate budesonide's effectiveness when administered via a metered dose inhaler with a modified Nebuhaler and Laerdal mask.
Main Methods:
- A double-blind, placebo-controlled crossover trial involving 24 infants (mean age 11 months).
- Assessment included device tolerance, adverse effects, treatment failures, parental opinion, and symptom/treatment records.
- Budesonide was administered using a metered dose inhaler into a large volume spacer (Nebuhaler) with an attached Laerdal mask.
Main Results:
- Twenty infants tolerated the modified Nebuhaler device.
- Budesonide treatment resulted in better mean symptom scores compared to placebo.
- Fewer bronchodilator doses were required during budesonide treatment.
- Eleven of 18 parents preferred budesonide over placebo for their children.
Conclusions:
- Budesonide, delivered via a modified Nebuhaler, is an effective treatment for managing wheezing symptoms in infants.
- This method of budesonide administration appears suitable for infants requiring prophylaxis for recurrent wheezing.
Abstract:
The role of budesonide in controlling chest symptoms in infants was assessed. It was administered from a metered dose inhaler into a large volume spacer (Nebuhaler) with attached Laerdal mask. Twenty nine infants were recruited into a double blind crossover trial. Five defaulted. The remaining 24 (mean age 11 months) were assessed for the tolerance of the device, adverse effects, treatment failures, parental opinion, and daily symptom and treatment records. Twenty tolerated the modified Nebuhaler. One developed meningitis on placebo. Two experienced exacerbations on placebo. Eleven of 18 parents whose children completed the maximum treatment preferred budesonide to placebo and one preferred placebo. Mean symptom scores on budesonide were better than on placebo for the 15 children with complete symptom records. Fewer bronchodilator doses were used while taking budesonide. Our findings indicate that budesonide given in this way is an effective treatment for infants who may need prophylaxis for their wheezing.