|
Clinical Question:
In children with an acute moderate-to-severe asthma exacerbation, is
levalbuterol (L-salbutamol) more effective and safer than albuterol (salbutamol)?
Bottom Line:
There was no difference in clinical improvement in children with acute
moderate to severe asthma exacerbations treated with either racemic
albuterol or levalbuterol.
Reference:
Qureshi F, Zaritsky A, Welch C, Meadows T, Burke BL. Clinical efficacy of
racemic albuterol versus levalbuterol for the treatment of acute pediatric
asthma. Ann Emerg Med 2005;46:29-36.
Study Design:
Randomized controlled trial (double-blinded)
Funding:
Industry
Setting:
Emergency department
Allocation:
Concealed
Synopsis:
An efficacy treatment study is conducted comparing levalbuterol to racemic
albuterol for acute pediatric asthma in the emergency department (ED). This
was a prospective, double-blind, randomized, controlled study involving 129
children (2 to 14 years), presenting to a pediatric ED with an acute
moderate or severe asthma exacerbation. Children were treated using a
standard ED asthma pathway. Primary outcomes were changes from baseline in
clinical asthma score and the percentage of predicted forced expiratory
volume in 1 second after the first, third, and fifth treatment. Secondary
outcomes included number of treatments, length of ED care, rate of
hospitalization, and changes in pulse rate, respiratory rate, and oxygen
saturation. Occurrence of adverse events was recorded. Sixty-four children
in the racemic albuterol and 65 children in the levalbuterol group completed
the study. There were no differences between groups in primary outcomes,
secondary outcomes, or adverse events. |