Comparison of clinical efficacy and safety between salbutamol-ipratropium bromide nebulization and salbutamol alone in children with asthmatic attack

Background Indonesian guidelines for childhood asthma recom- mend giving ipratropium bromide when there are no improvement after 2 times salbutamol nebulization. The efficacy and safety of early nebulization of ipratropium bromide combined with salbutamol as first line in moderate asthma exacerbation in children are still unknown. Objective To compare efficacy and safety between nebulized salbutamol-ipratropium bromide and salbutamol alone in children with moderate asthma exacerbation. Methods Fifty-two children (2-6 years) with acute asthma (clinical score 5-10) were enrolled into a randomized single blind controlled trial comparing 2 groups of 2.5 mg nebulized salbutamol (group 1) and 2.5 mg salbutamol combined with 0.5 mg ipratropium bromide (group 2). Nebulization was given until clinical score decreased 0.05). There were no toxic effects attributable to ipratropium bromide, and the side effects were not different between these two groups. Conclusion The combination of nebulized ipratropium bromide and salbutamol in a child with acute moderate asthma exacerba- tion was associated with higher reduction of clinical score and higher oxygen saturation, and may reduce hospitalization