Comparative Efficacy of Combination Nebulized Salbutamol and Fluticasone Propionate and Nebulized Salbutamol in Children with Mild Moderate Asthma Attack

Background: Short acting beta-2 agonist (SABA), systemic corticosteroids and oxygen are the primary therapy in asthma attack. Repeated use of systemic corticosteroid is at risk of systemic side effects. Inhaled corticosteroid offer potential benefit because of direct effect on the airways and lower systemic side effects.

Objective: To compare the efficacy between combination of nebulized salbutamol and fluticasone propionate and nebulized salbutamol in children with mild and moderate asthma attack.

Methods: Thirty children (age 5-14 years) with mild and moderate asthma attacks in outpatient clinic and emergency department of Soetomo hospital were investigated in an open label randomized controlled trial study. Subjects are divided into treatment group (combination of salbutamol and fluticasone propionate) and control group (salbutamol), each of the 15 children. Pulmonary score and side effects (tachycardia and tremor) was evaluated  at before and after nebulized at 20, 50 and 60 minutes. The statistical analysis used were t test, Mann Whitney test and the Wilcoxon signed rank test according to the type of data.

Results: The decreased pulmonary score at time evaluation was significant than before nebulized in both groups (p<0.05). The decreased pulmonary score in treatment group was greater than control group (p <0.05). Side effects such as tachycardia in both groups were not significantly different (p> 0.05) and tremor was not obtained in both groups.

Conclusion: Combination of nebulized salbutamol and fluticasone propionate had better efficacy than nebulized salbutamol in children with mild and moderate asthma attacks