Oral versus nebulized albuterol in the management of bronchiolitis in Egypt

Anne M. Gadomski, Galal H. Aref, Omneya Badr el Din, Ihab Hafez el Sawy, Nagwa Khallaf, Robert E. Black

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


The efficacy of albuterol in the management of infants with first-time wheezing is controversial. This double-blind, placebo-controlled trial involved 128 Egyptian infants with first-time wheezing (mean age 5.9 months) who were randomly separated into four equivalent therapy groups: nebulized albuterol, nebulized saline solution, orally administered albuterol, and orally administered placebo. The nebulized therapy groups received two treatments 30 minutes apart; the oral therapy groups received one treatment. In addition, 41 infants with recurrent wheezing comprised an open-label control group who received two albuterol nebulizations. Chest radiographs, leukocyte counts, blood culture specimens, and nasal aspirate for viral antigen detection were obtained to confirm the clinical diagnosis of viral bronchiolitis. Respiratory and heart rates, clinical score, and oxygen saturation were recorded at baseline and 30 and 60 minutes after treatment. There was no difference among the four randomized groups in any of the outcomes except for an increase in heart rate of 10 beats/min in the nebulized albuterol group compared with a decrease in heart rate of 8 beats/ min in the oral placebo group. No differences in the need for additional treatment were observed. Nebulized albuterol significantly improved the clinical score and reduced the respiratory rate of those with recurrent wheezing relative to those in the randomized groups. We conclude that nebulized albuterol is effective in the treatment of infants with recurrent wheezing, but there was no dem-onstrable efficacy of orally administered or nebulized albuterol in relieving the respiratory distress of infants with bronchiolitis in Egypt. (J PEDIATR 1994;124:131-8)

Original languageEnglish (US)
Pages (from-to)131-138
Number of pages8
JournalJournal of Pediatrics
Issue number1
StatePublished - Jan 1 1994


  • ARI
  • Acute respiratory tract infection
  • Analysis of variance
  • CXR
  • Chest radiograph
  • HR
  • Heart rate
  • Oxygen saturation as measured by pulse oximetry
  • RR
  • RSV
  • Respiratory rate
  • Respiratory syncytial virus
  • SpO

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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