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Combined inhaled anticholinergics and short-acting beta2-agonists for initial treatment of acute asthma in children

  1. Benedict Griffiths1,*,
  2. Francine M Ducharme2,3

Editorial Group: Cochrane Airways Group

Published Online: 21 AUG 2013

Assessed as up-to-date: 18 APR 2012

DOI: 10.1002/14651858.CD000060.pub2


How to Cite

Griffiths B, Ducharme FM. Combined inhaled anticholinergics and short-acting beta2-agonists for initial treatment of acute asthma in children. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD000060. DOI: 10.1002/14651858.CD000060.pub2.

Author Information

  1. 1

    St Thomas' Hospital, Evelina Children's Hospital, London, UK

  2. 2

    University of Montreal, Department of Paediatrics, Montreal, Québec, Canada

  3. 3

    CHU Sainte-Justine, Research Centre, Montreal, Canada

*Benedict Griffiths, Evelina Children's Hospital, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK. bgriffiths@doctors.org.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 AUG 2013

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Beck 1985 {published data only}
  • Beck R. Use of ipratropium bromide by inhalation in the treatment of acute asthma in children. Clinical experience [in French] [Utilisation du bromure d'ipratropium par voie inhalée pour le traitement de l'asthme aigu chez l'enfant]. Archives de Pediatrie 1995;2 Suppl(2):145-8.
  • Beck R, Robertson C, Galdes-Sebaldt M, Levison H. Combined salbutamol and ipratropium bromide by inhalation in the treatment of severe acute asthma. Journal of Pediatrics 1985;107:605-8.
Benito Fernandez 2000 {published data only}
  • Benito Fernandez J, Mintegui Raso S, Sanchez Echaniz J, Vazquez Ronco MA, Pijoan Zubizarreta JI. Efficacy of early administration of nebulized ipratropium bromide in children with asthmatic crisis [in Spanish]. Anales Espanoles de Pediatria 2000;53(3):217-22.
BI [pers comm] {published data only}
  • Boehringer Ingelheim Pharmaceuticals. A comparison of Combivent UDV (ipratropium 500mcg and salbutamol 2.5mg) and salbutamol UDV alone (2.5mg). Personal communication from Boehringer Ingelheim 2009.
Calvo 1998 {published data only}
  • Calvo GM, Calvo AM, Marin HF, Moya GJ. Is it useful to add an anticholinergic treatment to beta2-adrenergic medication in acute asthma attack. Journal of Investigative Allergology Clinical Immunology 1998;8(1):30-4.
Chakraborti 2006 {published data only}
  • Chakraborti A, Lodha R, Pandey RM, Kabra SK. Randomized controlled trial of ipratropium bromide and salbutamol versus salbutamol alone in children with acute exacerbation of asthma. Indian Journal of Pediatrics. 2006;73(11):979-83.
Cook 1985 {published data only}
Ducharme 1998 {unpublished data only}
  • Ducharme FM, Davis GM. Randomized controlled trial of ipratropium bromide and frequent low doses of salbutamol in the treatment of mild and moderate acute asthma. Journal of Pediatrics 1998;133(4):479-85.
Guill 1987 {published data only}
  • Guill MF, Maloney MJ, DuRant RH. Comparison of inhaled metaproterenol, inhaled atropine sulfate and their combination in treatment of children with acute asthma. Annals of Allergy 1987;59:367-71.
Iramain 2011 {published data only}
  • Iramain R, Lopez-Herce J, Coronel J, Spitters C, Guggiari J, Bogado N. inhaled salbutamol plus ipratropium in moderate and severe asthma crises in children. Journal of Asthma 2011;48:298-303.
Peterson 1996 {unpublished data only}
  • Peterson R, Wensley D, Mitchell I, Klassen T, Lamarre J, Rivard G, et al. Boehringer Ingelheim Trial No 2442430.3. Boehringer Ingelheim 1994.
Phanichyakam 1990 {published data only}
  • Phanichyakam P, Kraisarin C, Sasisakulporn C. Comparison of inhaled terbutaline and inhaled terbutaline plus ipratropium bromide in acute asthmatic children. Asian Pacific Journal of Allergy and Immunology 1990;8:45-8.
Qureshi 1997 {published data only}
Qureshi 1998 {published data only}
Qureshi 1998 (moderate) {published data only}
Qureshi 1998 (severe) {published data only}
Reisman 1988 {published data only}
  • Reisman J, Galdes-Sebaldt M, Kazim F, Canny G, Levison H. Frequent administration by inhalation of salbutamol and ipratropium bromide in the initial management of severe acute asthma in children. Journal of Allergy & Clinical Immunology 1988;81:16-20.
Schuh 1995 {published data only}
  • Schuh S, Johnson DW, Callahan S, Canny G, Levison H. Efficacy of frequent nebulized ipratropium added to frequent high-dose albuterol therapy in severe childhood asthma. Journal of Pediatrics 1995;126:639-45.
Schuh 1995 (multiple) {published data only}
  • Schuh S, Johnson DW, Callahan S, Canny G, Levison H. Efficacy of frequent nebulized ipratropium added to frequent high-dose albuterol therapy in severe childhood asthma. Journal of Pediatrics 1995;126:639-45.
Schuh 1995 (single) {published data only}
  • Schuh S, Johnson DW, Callahan S, Canny G, Levison H. Efficacy of frequent nebulized ipratropium added to frequent high-dose albuterol therapy in severe childhood asthma. Journal of Pediatrics 1995;126:639-45.
Sharma 2004 {published data only}
  • Sharma A, Madaan A. Nebulized salbutamol vs salbutamol and ipratropium combination in asthma. Indian Journal of Pediatrics 2004;71(2):121-4.
Sienra Monge 2000 {published data only}
  • Sienra Monge JJ, Bermejo Guevara MA, del Rio Navarro BE, Rosas Vargas MA, Reyes Ruiz NI. Degree and duration of bronchodilatation with an agonist beta 2 administered alone versus an agonist beta 2 administered with ipratropium bromide in children with acute asthma. Revista Alergia Mexico 2000;47(1):26-9.
Watanasomsiri 2006 {published data only}
  • Watanasomsiri A, Phipatanakul W. Comparison of nebulized ipratropium bromide with salbutamol versus salbutamol alone in acute asthma exacerbation in children [Abstract]. Chest 2004;126(4 Suppl):761S-b.
  • Watanasomsiri A, Phipatanakul W. Comparison of nebulized ipratropium bromide with salbutamol vs salbutamol alone in acute asthma exacerbation in children. Annals of Allergy, Asthma, & Immunology 2006;96(5):701-6.
Watson 1988 {published data only}
  • Watson WTA, Becker AB, Simmons FER. Comparison of ipratropium solution, fenoterol solution and their combination administered by nebulizer and face mask to children with acute asthma. Journal of Allergy & Clinical Immunology 1988;82:1012-8.
Zorc 1999 {published data only}
Zorc 1999 (mild) {published data only}
Zorc 1999 (moderate) {published data only}
Zorc 1999 (severe) {published data only}

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Anthracopoulos 2005 {published data only}
  • Anthracopoulos M, Karatza A, Davlouros PA, Beratis NG. Comparison of salbutamol (SAL) and combined salbutamol and ipratropium bromide (SAL+IB) nebulization therapy in acute asthma exacerbations (AAE) in paediatric patients. European Respiratory Journal 2000;16 Suppl 31:304s.
  • Anthracopoulos MB, Karatza AA, Davlouros PA, Chiladakis JA, Manolis AS, Beratis NG. Effects of two nebulization regimens on heart rate variability during acute asthma exacerbations in children. Journal of Asthma 2005;42(4):273-9.
Boner 1987 {published data only}
  • Boner AL, De Stefano G, Niero E, Vallone G, Gaburro D. Salbutamol and ipratropium bromide solution in the treatment of bronchospasm in asthmatic children. Annals of Allergy 1987;58:54-8.
Bratteby 1986 {published data only}
  • Bratteby L-E, Foucard T, Lonnerholm G. Combined treatment with ipratropium bromide and beta-2-adrenoceptor agonists in childhood asthma. American Review of Respiratory Disease 1986;68:239-47.
Browne 2002 {published data only}
  • Browne GJ, Trieu L, Van Asperen P. Randomized, double-blind, placebo-controlled trial of intravenous salbutamol and nebulized ipratropium bromide in early management of severe acute asthma in children presenting to an emergency department. Critical Care Medicine 2002;30(2):448-53.
Caubet 1989 {published data only}
  • Caubet Y. Comparison of the effectiveness and the tolerance of the dosing aerosols of fenoterol/ipratropium against salbutamol in the asthmatic child [in French] [Comparaison de l'efficacite et de la tolerance des aerosols doseurs de l'association fenoterol/ipratropium contre le salbutamol chez le grand enfant asthmatique]. La Revue de Pediatrie 1989;25(2):74-6.
Craven 2001 {published data only}
  • Craven D, Kercsmar CM, Myers TR, O'Riordan MA, Golonka G, Moore S. Ipratropium bromide plus nebulized albuterol for the treatment of hospitalized children with acute asthma. Journal of Pediatrics 2001;138(1):51-8.
Davis 1984 {published data only}
  • Davis A, Vickerson F, Worsley G, Mindorff C, Kazim F, Levison H. Determination of dose-response relationship for nebulized ipratropium in asthmatic children. Journal of Pediatrics 1984;Dec:1002-5.
Delacourt 1994 {published data only}
  • Delacourt C, de Blic J, Lebourgeois M, Scheinmann P. Value of ipratropium bromide in asthma crisis in children [in French] [Interet du bromure d'ipratropium dans la crise d'asthme de l'enfant]. Archives de Pediatrie 1994;1:87-92.
DeStefano 1989 {published data only}
  • DeStefano G, Bonetti S, Bonizzato C, Valletta EA, Piacentini GL, Boner AL. Additive effect of albuterol and ipratropium bromide in the treatment of bronchospasm in children. Annals of Allergy 1989;65(4):260-2.
Ekwo 1978 {published data only}
Freeman 1989 {published data only}
Friberg 1989 {published data only}
Goggin 2001 {published data only}
  • Goggin N, Macarthur C, Parkin PC. Randomized trial of the addition of ipratropium bromide to albuterol and corticosteroid therapy in children hospitalized because of an acute asthma exacerbation. Archives of Pediatrics & Adolescent Medicine 2001;155(12):1329-34.
Greenough 1986 {published data only}
  • Greenough A, Loftus Bg, Pool J, Price JF. Response to bronchodilators assessed by lung mechanics. Archives of Disease in Childhood 1986;61:1020-3.
  • Greenough A, Yuksel B, Everett L, Price JF. Inhaled ipratropium bromide and terbutaline in asthmatic children. Respiratory Medicine 1993;87:111-4.
Groggins 1981 {published data only}
  • Groggins RC, Milner AD, Stokes GM. Bronchodilator effects of clemastine, ipratropium bromide, and salbutamol in preschool children with asthma. Archives of Disease in Childhood 1981;56:342-4.
Hodges 1981 {published data only}
  • Hodges IGC, Groggins RC, Milner AD, Stokes GM. Bronchodilator effect of inhaled ipratropium bromide in wheezy toddlers. Archives of Disease in Childhood 1981;56:729-32.
Kumaratne 2003 {published data only}
  • Kumaratne M, Gunawardane G. Addition of ipratropium to nebulized albuterol in children with acute asthma presenting to a pediatric office. Clinical Pediatrics 2003;42(2):127-32.
Lenney 1986 {published data only}
Mann 1982 {published data only}
O'Driscoll 1989 {published data only}
  • O'Driscoll BR, Taylor RJ, Horsley MG, Chambers DK, Bernstein A. Nebulised salbutamol with and without ipratropium bromide in acute airflow obstruction. Lancet 1989;1(8652):1418-20.
Paredes 1994 {published data only}
  • Paredes N, Sol M, Del Rio N, Sienra M. Comparative efficacy of salbutamol versus salbutamol with ipratropium bromide in acute asthma in children [Abstract]. XV International Congress of Allergology and Clinical Immunology: Annual Meeting of the European Academy of Allergology and Clinical Immunology. 1994:377.
Ralston 2005 {published data only}
  • Ralston ME, Euwema MS, Knecht KR, Ziolkowski TJ, Coakley TA, Cline SM. Comparison of levalbuterol and racemic albuterol combined with ipratropium bromide in acute pediatric asthma: a randomized controlled trial. Journal of Emergency Medicine 2005;29(1):29-35.
Rayner 1987 {published data only}
  • Rayner RJ, Cartlidge PHT, Upton CJ. Salbutamol and ipratropium in acute asthma. Archives of Disease in Childhood 1987;62:840-1.
Stokes 1983 {published data only}
  • Stokes GM, Milner AD, Hodges IGC, Henry RL. Nebulised ipratropium bromide in wheezy infants and young children. European Journal of Respiratory Diseases 1983;64:494-8.
Storr 1986 {published data only}
  • Storr J, Lenney W. Nebulised ipratropium and salbutamol in asthma. Archives of Disease in Childhood 1986;61:602-3.
Timsit 2002 {published data only}
  • Timsit S, Sannier N, Bocquet N, Cojocaru B, Wille C, Boursiquot C, et al. Benefit of ipratropium bromide for the treatment of childhood asthma in the emergency department. Archives de Pediatrie 2002;9(2):117-24.
Vichyanond 1990 {published data only}
Ward 1981 {published data only}
  • Ward MJ, Fentem PH, Smith WH, Davies D. Ipratropium bromide in acute asthma. British Medical Journal Clinical Research Ed. 1981;282(6264):598-600.
Ward 1985 {published data only}
Wilson 1984 {published data only}

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Arets 2001
BTS 2011
  • British Thoracic Society and Scottish intercollegiate Guidelines Network. British guideline on the management of asthma: a national clinical guideline, 2011. www.brit-thoracic.org.uk/guidelines (accessed 8 August 2013).
Chalut 2000
Chapman 1996
DerSimonian 1986
Ducharme 2008
  • Ducharme FM, Chalut D, Plotnick L, Savadie C, Kudrika D, Zhang Xun, et al. The Pediatric Respiratory Assessment Measure: a valid clinical score for assessing acute asthma severity from toddlers to teenagers. Journal of Pediatrics 2008;152(4):476-80.
GINA 2011
  • Global INitiative for Asthma. Global strategy for asthma management and prevention, 2011. www.ginasthma.org (accessed 8 August 2013).
Greenland 1985
Gross 1988
  • Gross NJ. Ipratropium bromide. New England Journal of Medicine 1988;8:486-94.
Higgins 2011
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Homer 1996
  • Homer CJ, Szilagyi P, Rodewald L, Bloom SR, Greenspan P, Yazdgerdi S, et al. Does quality of care affect rates of hospitalization for childhood asthma?. Pediatrics 1996;98:18-23.
Khan 1996
  • Khan KS, Daya S, Jahad AR. The importance of quality of primary studies in producing unbiased systematic reviews. Archives of Internal Medicine 1996;156:661-6.
Lougheed 2012
  • Lougheed MD, Lemiere C, Ducharme FM, Licskai C, Dell SD, Rowe BH, et al. Canadian Thoracic Society 2012 guideline update: diagnosis and management of asthma in preschoolers, children and adults. Canadian Respiratory Journal 2012; Vol. 19, issue 2:127-64. [1916-7245: (Electronic)]
Payne 1995
  • Payne SM, Donahue C, Rappo P, McNamara JJ, Bass J, First L, et al. Variations in pediatric pneumonia and bronchitis/asthma admission rates. Is appropriateness a factor?. Archives of Pediatric and Adolescent Medicine 1995;149:162-9.
RevMan 2011
  • The Nordic Cochrane Centre: The Cochrane Collaboration. Review Manager (RevMan). 5.1. Copenhagen: The Nordic Cochrane Centre: The Cochrane Collaboration, 2011.
Rodrigo 2005
  • Rodrigo G, Castro-Rodriguez J. Anticholinergics in the treatment of children and adults with acute asthma: a systematic review with meta analysis. Thorax 2005;60:740-6.
Rowe 2001
  • Rowe BH, Spooner C, Ducharme F, Bretziaff J, Bota G. Early emergency department treatment of acute asthma with systemic corticosteroids. Cochrane Database of Systematic Reviews 2001, Issue 1. [DOI: 10.1002/14651858.CD002178]
Rubin 2003
  • Rubin BK, Fink JB. The delivery of inhaled medication to the young child. Pediatric Clinics of North America 2003; Vol. 50, issue 3:717-31. [0031-3955: (Print)]
Saxena 2006
  • Saxena S, George J, Barber J, Fitzpatrick J, Majeed A. Association of population and practice factors with potentially avoidable admissions rates for chronic diseases in London: cross sectional analysis. Journal of the Royal Society of Medicine 2006;99(2):81-9.
Sears 1992
  • Sears MR. Clinical application of beta-agonists. Practical Allergy and Immunology 1992;7:98-100.
Silverman 1990
Silverman 2007
Svedmyr 1985
  • Svedmyr N. A beta2-adrenergic agonist for use in asthma pharmacology, pharmacokinetics, clinical efficacy and adverse effects. Pharmacotherapy 1985;5:109-26.
Teoh 2012

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Plotnick 2000
  • Plotnick L, Ducharme F. Combined inhaled anticholinergics and beta2-agonists for initial treatment of acute asthma in children. Cochrane Database of Systematic Reviews 2000, Issue 3. [DOI: 10.1002/14651858.CD000060]