The goal of the study was to test the hypothesis that adding high-dose nebulized budesonide to standard asthma treatment in children in the emergency department (ED) during the first hour would decrease their hospital admission rate.

The study population included children aged 2 to 12 years with physician-diagnosed asthma (or previous episodes of shortness of breath responsive to a β-agonist) who presented to the ED with a moderate or severe acute asthma exacerbation.

Children were randomized within the pharmacy (double-blind) to receive 3 doses of 500 μg/dose of budesonide or placebo with a β-agonist (salbutamol + ipratropium bromide) via nebulization every 20 minutes over 1 hour. They also received prednisolone 2 mg/kg (maximum dose of 60 mg). Asthma severity was assessed by using a previously studied asthma scoring system. Patients were assessed at baseline and 1 and 2 hours after initiation of medication. Those who remained in the ED were...

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