A 500‐ml plastic bottle: An effective spacer for children with asthma

Abstract

Inhaled therapy using a metered-dose inhaler (MDI) with attached spacer has been increasingly recognized as the optimal method for delivering asthma medication for acute attacks and chronic prophylaxis. However, in developing countries the cost and availability of commercially produced spacers limit the use of MDI-spacer delivery systems. A 500-ml plastic bottle has been recently adapted to function as a spacer. This article reviews the current data on the efficacy of this bottle-spacer and discusses its advantages and limitations. It is concluded that a modified 500-ml plastic bottle is an effective spacer; modification and use of this device should be incorporated into international guidelines for the management of children with asthma.

Performance of a Corticosteroid Inhaler with a Spacer Fashioned from a Plastic Cold-Drink Bottle: Effects of Changing Bottle Volume

“…However, our results are inconsistent with previous studies that demonstrated superiority of a 500-mL plastic bottle in comparison with the MDI alone (17,18,20). The reason for this is unclear; however, the plastic bottles we used did not have the same shape as the one tested in previous studies (17,18,20). Although our bottles had rather short necks (see Fig.…”

“…Our results are also consistent with previous studies that have shown that adding a spacing device to an MDI reduces the oropharyngeal dose (30,31). However, our results are inconsistent with previous studies that demonstrated superiority of a 500-mL plastic bottle in comparison with the MDI alone (17,18,20). The reason for this is unclear; however, the plastic bottles we used did not have the same shape as the one tested in previous studies (17,18,20).…”

“…This bottle spacer has been shown to be equivalent or superior to most spacers commercially available in the United States (17). The 500-mL cold-drink bottle used in these studies was larger than the 300-mL volume previously determined to be optimum for a budesonide MDI, and smaller than the 1000 mL volume determined optimum for a cromolyn MDI (21).…”

“…Additionally, MDI spacers can be quite expensive ($25-50) and are often not covered by prescription insurance plans. Some clinicians (especially those serving economically disadvantaged areas) advocate that an inexpensive MDI spacer can be extemporaneously prepared from common household items such as bottles, cardboard tubes, and cups (16,17). Despite that a person can physically prepare a MDI spacer from such items, limited data on their efficacy exist in patients with asthma (18,19).…”

“…The most promising of these ''homemade'' MDI spacers is one fashioned from a 500-mL cold-drink bottle (17,20). This bottle spacer has been shown to be equivalent or superior to most spacers commercially available in the United States (17).…”