1. Home>
2. Specialties>
3. Emergency Medicine>
4. Summary and Comment

Ipratropium Decreases Asthma Hospitalization Rates

Studies have shown that the use of an anticholinergic medication, such as ipratropium bromide, along with standard therapy, improves pulmonary function in asthmatic children. This study assessed whether ipratropium bromide added to inhaled beta agonist and corticosteroid therapy reduces the hospitalization rate of children with asthma exacerbations.

Researchers randomized 434 children with moderate to severe asthma exacerbations to either 500 µg (2.5 ml) of ipratropium or placebo mixed with the second and third doses of nebulized albuterol and 2 mg/kg of oral corticosteroid. Fewer children receiving ipratropium bromide were admitted (59 of 215, 27.4%) than those receiving placebo (80 of 219, 36.5%, p=0.05). Among patients with severe asthma, but not those with moderate asthma, the administration of ipratropium significantly reduced the need for hospitalization (51 of 136 children, 37.5%, compared with 71 of 135, 52.6%, p=0.02).

Comment: Similar studies have suggested that ipratropium bromide did not decrease hospitalization rates, but this study used a higher dose of ipratropium bromide and enrolled more patients. The current findings are compelling, but confirmatory research is required.

— JG Adams

Published in Journal Watch Emergency Medicine November 1, 1998

Citation(s):

Qureshi F et al. Effect of nebulized ipratropium on the hospitalization rates of children with asthma. N Engl J Med 1998 Oct 8 339 1030-1035.

• Original article (Subscription may be required)
• Medline abstract (Free)