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[Nebulized corticosteroids and pediatricians: results of the NUAGES survey]
M Salles1, M de Monte, J-C Dubus
1Unité de médecine infantile, URMITE 6236, CNRS, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
Introduction:
The aim of the study was to analyze the data of the NUAGES survey (a survey on the practice of nebulization in France), concerning the prescriptions of nebulized steroids from 514 pediatricians.
Material And Methods:
The reason why nebulization was chosen as a delivery route, the diseases motivating the prescription, the age of the patients, the kind of drug used, and the prescription and device modalities were studied.
Results:
Efficacy in treating various respiratory diseases was the main reason cited for using nebulization, in particular severe persistent asthma (76%). Pediatricians prescribed nebulization mainly to infants (60%). The most frequently used drug was budesonide suspension (89%), but the intravenous route for steroids (18%) and drug admixtures (62%) were also proposed by nebulization. A specific prescription for the nebulizer was given in 75% of the cases, with the type of interface to use specified in 66%.
Discussion:
Pediatricians consider that nebulization is well adapted to young children. Although the proper steroid is usually chosen, unfortunately, it is often prescribed with other drugs, with 1 prescription out of 4 not following the recommendations. Prescription of the device is not optimal and may compromise the efficacy of the treatment.
Conclusion:
Nebulization is a potential mode of delivery for steroids that is difficult to prescribe and warrants improved pediatrician training.
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