Nebulised Sodium Cromoglycate in the Treatment of Wheezy Bronchitis in Infants and Young Children

Abstract

44 children under 2 years of age suffering from recurrent or persistent wheezy bronchitis, completed a double-blind crossover trial comparing nebulised sodium cromoglycate and matching placebo. Analysis showed that treatment response was age-related. Sodium cromoglycate proved significantly superior to placebo in reducing night cough, sleep disturbance, wheeze and activity limitation in the 24 patients aged 12 months and above (mean 17.3) on entry to the study. Whereas no significant differences were observed in the 20 children below 12 months of age (mean 8.3). These findings were confirmed by weekly clinical assessments, Both age groups spent fewer days in hospital during the active treatment period. Final subjective assessments showed that in the older age group, parents favoured cromoglycate treatment, whereas in the younger age group, parents favoured placebo, although neither reached statistical significance. Both age groups showed marked placebo response to nebulised water.

Randomised placebo-controlled trial of inhaled sodium cromoglycate in 1–4-year-old children with moderate asthma

“…We could not identify subgroups of children whose response to cromoglycate was influenced by age, sex, positive family history, atopic history, season, or smoking habits of the parents. GellerBernstein and Levin 11 found an effect of cromoglycate in children aged 12 months and older, whereas no effect was seen in children below this age.…”

“…6,7 Despite widespread use, the effect of inhaled sodium cromoglycate in very young children with moderate asthma has hardly been studied. Several placebocontrolled trials [8][9][10][11][12][13][14][15][16][17][18] have been reported but most were hospital-based, studied patients with severe asthma, had follow-up periods shorter than 10 weeks, and studied medication inhaled by nebulisation. Six of these studies showed improvement of symptoms in comparison with placebo, [8][9][10][11][12][13] but in five sodium cromoglycate was no better than placebo.…”

“…Several placebocontrolled trials [8][9][10][11][12][13][14][15][16][17][18] have been reported but most were hospital-based, studied patients with severe asthma, had follow-up periods shorter than 10 weeks, and studied medication inhaled by nebulisation. Six of these studies showed improvement of symptoms in comparison with placebo, [8][9][10][11][12][13] but in five sodium cromoglycate was no better than placebo. [14][15][16][17][18] Data on the prescription of antiasthma drugs in primary and secondary care show a trend of decreasing use of sodium cromoglycate and increasing use of inhaled steroids.…”

Gastroesophageal reflux in infants with wheezing

“…8 In most infants with GER and wheezing, appropriate medical management improves GER and respiratory symptoms secondary to GER. 1,9,10 Management of infants with daily wheezing is difficult, and the role of asthma medications such as oral theophylline 11 and nebulized sodium cromoglycate 12,13 is controversial. This may be because infantile wheezing is a common presentation with many different etiologies, such as exposure to smoking, GER, upper respiratory viral infections, or asthma.…”

The effect of sodium cromoglycate on upper and lower respiratory symptoms in children born prematurely

“…Sodium cromoglycate (SCG) is a useful prophylactic agent in symptomatic children less than 5 years of age [1,4,6]. In a randomised controlled trial [13] …”