The safety and efficacy of nebulized ipratropium bromide/fenoterol and magnesium sulfate was compared in children with moderate-to-severe asthma exacerbation, with no adverse events reported.
Nebulized ipratropium bromide/fenoterol is frequently administered in combination with salbutamol for severe exacerbation of asthma. Recent studies implicate the addition of nebulized magnesium sulfate in the treatment regimen for severe asthma. This prospective randomized controlled trial, published in the Asian Pacific Journal of Allergy and Immunology, compared the safety and efficacy of nebulized ipratropium bromide/fenoterol and magnesium sulfate in patients with moderate-to-severe exacerbation of asthma.
The study included a total of 33 children with an age range of 2–15 years, with pediatric respiratory assessment measure (PRAM) scores of ≥ 4 demonstrating moderate-to-severe asthma exacerbation, regardless of the administration of three nebulized salbutamol doses. The study participants were randomized to receive three doses of nebulized ipratropium bromide/fenoterol or magnesium sulfate every 30 minutes. The investigators measured the PRAM score at 0, 0.5, 1, 1.5, 2, and 4 hours after the treatment. The investigators also evaluated the admission days and adverse effects on the patients.
Of the 33 children, 17 were given nebulized ipratropium bromide/fenoterol, and the remaining 16 were administered nebulized magnesium sulfate. Almost all of the patients were reported to have moderate asthma exacerbation. The investigators found no statistical difference between the treatment groups based on PRAM scores at 0, 0.5, 1.5, 2, and 4 hours. Similarly, the length of stay at the hospital was similar between the two treatment groups, at 3.86 ± 1.5 days in patients receiving nebulized ipratropium bromide/fenoterol and 3.76 ± 1.1 days in patients receiving nebulized magnesium sulfate. Treatment groups reported no adverse effects, and both groups had no significant difference in levels of magnesium.
In summary, this study compared the safety and efficacy of nebulized ipratropium bromide/fenoterol and nebulized magnesium sulfate, demonstrating that the treatment outcomes are comparable. Larger sample sizes are recommended for future studies.
Wongwaree, S., & Daengsuwan, T. (2022). Comparison efficacy of randomized nebulized magnesium sulfate and ipratropium bromide/fenoterol in children with moderate to severe asthma exacerbation. Asian Pacific Journal of Allergy and Immunology, 40(1), 31-38. https://doi.org/10.12932/ap-190717-0118