Pilgrim's progress: the effect of salmeterol in older children with chronic severe asthma

AbstractTwenty-four children aged 12–17 years entered a randomized, double-blind placebo-controlled study investigating the use of salmeterol in chronic severe asthma. In addition to their usual medication, the children were given either placebo or 100 μg salmeterol b.d. by dry powder inhalation. Treatment was continued throughout one term at a residential school for asthma. Symptom scores, peak expiratory flow rates, spirometry and quality-of-life scores were compared between the two treatment groups.One child withdrew during the run-in period. Twelve pupils received placebo and 11 pupils received salmeterol. There were consistent improvements in favour of salmeterol, reaching statistical significance for morning and evening peak flow rates and spirometry when measured on four occasions during the study period. There were no medication-related adverse events recorded and no pulse rate changes. Salmeterol (100 μg b.d.) is well tolerated and efficacious in older children with chronic severe asthma

Prednisolone in acute childhood asthma: clinical responses to three dosages

AbstractNinety-eight children aged 1–15 years entered a randomized double-blind study investigating an appropriate dose of oral prednisolone in children admitted to hospital with an acute exacerbation of asthma. None of the children had recently been treated with oral prednisolone. Following admission, the children were randomized to receive prednisolone 0·5 mg kg−1, 1·0 mg kg−1 or 2·0 mg kg−1 in a single daily dose in addition to nebulized bronchodilators. Clinical asthma scores, oxygen saturations, pulse rate, duration of admission and number of nebulizers given were compared in the three treatment groups.Thirty-five children received 0·5 mg kg−1, 33 received 1·0 mg kg−1 and 30 received 2·0 mg kg−1. There were no significant differences in the pattern of recovery between the three treatment groups. There were no advantages in using higher doses of prednisolone. We recommend 0·5 mg kg−1 day−1 of prednisolone as an appropriate dose for treating an acute exacerbation of asthma