Inhaled budesonide versus oral prednisolone in the treatment of acute exacerbation of moderate bronchial asthma: an open label randomized clinical trial

Reashma Roshan, Mubashir H. Shah, Aejaz A. Bhat


Background: Recently published studies have suggested that inhaled corticosteroids may offer benefit over systemic steroids in bronchial asthma. This research was carried out to study the efficacy of inhaled budesonide and to compare the efficacy of inhaled budesonide with oral prednisolone in the treatment of acute moderate asthma in children.

Methods: This was an open label randomized clinical trial. Children in the age group of 1-12 years with acute exacerbation of asthma presenting to pediatric emergency from November 1, 2015 to October 31, 2016 who fail to show prompt improvement after initial treatment with oxygenand three doses of inhaled salbutamol, were enrolled. Children in group B (n=35) and group P (n=35) received inhaled budesonide and oral prednisolone, respectively, in addition to oxygen inhalation and salbutamol as per the study protocol. Outcome was measured in terms of pulmonary score at the beginning, at 6 hours, and at 24 hours of starting the treatment. The analysis was undertaken according to intent to treat principle.

Results: Baseline characteristics (sex, age, weight, height, body mass index) were comparable in the 2 groups. Mean heart rate, respiratory rate, pulmonary score at 6 and 24 hours, mean SpO2 at 24 hours were significantly showing normalizing trend (p<0.05) and mean hospital stay was significantly reduced [2.60 (±0.60) vs 3.11 (±0.80); p<0.05] in group B as compared to group P.

Conclusions: Outcome measures of clinical improvement were better in inhaled budesonide group than oral prednisolone group in acute moderate exacerbation of bronchial asthma.



Asthma, Steroids, Inhaled, Budesonide, Prednisolone

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