Spirometry Findings Following Treatment with Oral and Inhalant Corticosteroids in Mild to Moderate Asthma Exacerbation in Children

Introduction Asthma exacerbation is common in children. Treatment with Oral corticosteroids (OCS) and inhaled corticosteroids are suggested for asthma exacerbation. It is shown that inhaled corticosteroids has similar outcome in reducing asthma symptoms compared to OCS. But few studies have evaluated the pulmonary function changes in these two treatments. In this study, we evaluated the changes in pulmonary function tests in children with mild-to-moderate asthma exacerbation receiving oral prednisolone and inhaled Budesonide. Methods and Materials Forty-four children with mild-to-moderate asthma exacerbation were randomly assigned to receive oral prednisolone (2 mg/kg) or Budesonide spray (2 puffs every 12 hours, each puff contains 200 microgram Budesonide) using a spacer for one week. The first dose of the treatment was given in the emergency department. Children were followed for seven days and spirometry findings before and after treatment were evaluated. Results There was no significant difference between pulmonary function tests before and after treatment between groups. Children receiving oral prednisolone had significantly more improvement in Peak expiratory flow (PEF) (p=0.01). There was significant improvement in all respiratory parameters after treatment in both groups (p<0.05), but PEF had no significant change after treatment s in inhaled Budesonide group (p=0.63). Conclusion Both inhaled Budesonide and oral prednisolone significantly improved respiratory function in children with mild-to-moderate asthma exacerbation. As there was no significant difference between groups in Pulmonary function tests (PFT) findings and due to the low systemic effects of inhaled budesonide compared to oral prednisolone, this treatment seems to be more appropriate in mild to moderate exacerbations.