Efficacy of salbutamol .. ipratropium bromide nebulization compared to salbutamol alone in children with mild to moderate asthma attacks

Background The efficacy of salbutamol-ipratropiumbromide nebulization in children with moderate asthma attacks remains unclear, and studies on patients with mild attacks have been relatively few, especially in Indonesia. However, it is common practice for this drug combination to be given to patients with mildSmoderate asthma attacks. Objective To compare the efficacy of salbutamolSipratropium bromide nebulization to salbutamol alone in children v.ith mild to moderate asthma attacks. Methods This single-blind, randomized clinical trial was held in the Department of Child Health at Cipto Mangunkusumo
Hospital, the Tebet Community Health Center, and the MH Thamrin Salemba Hospital on children aged 5S18 years with mild to moderate asthma attack. We randomized subjects to receive either 2.5 mg salbutamol plus 0.5 mg ipratropium bromide (experimental group) or 2.5 mg salbutamol alone (control group). Nebulization was given twice, with a 20 minute interval between treatments. We assessed clinical scores, vital signs, oxygen saturations, and peak flow rates (PFRs) at baseline, and every 20 minutes up to 120 minutes post-nebulization . Results A total of 46 patients were randomized to either the
experimental or the control group. Subjects had similar baseline measurements. At 20 minutes postSnebulization, the percentage increase of PFR was 19% higher in the experimental group (p=O.OI, 95% CI 1.8 to 47.2). The proportion of PFR reversibility was 27% higher in the experimental group, although this result
was statistically insignificant (P=0.06, 95% CI 0.03 to 0.52). There were no significant differences in clinical scores, oxygen saturations, respiratory rates, or hospitalization rates between the two groups. Side effects also did not differ significantly. Concl usion SalbutamolSipratropium bromide nebulization
improved PFR measurements better than salbutamol alone. However, other clinical parameters were not significantly different between the two groups.