Effectiveness of nebulized N-acetylcysteine solution in children with acute bronchiolitis

J Coll Physicians Surg Pak. 2014 Jun;24(6):408-11.


Objective: To evaluate the effectiveness of nebulized mucolytic therapy (N-acetylcysteine) in treatment of children with acute bronchiolitis.

Study design: Prospective randomized, controlled study.

Place and duration of study: Paediatric Medical Unit of the Children's Hospital and the Institute of Child Health, Lahore, from November 2011 to April 2012.

Methodology: All the patients aged 2 months to 24 months, with the diagnosis of acute viral bronchiolitis were enrolled in the study. A predesigned proforma was completed after taking parental consent. All eligible patients were randomly assigned to one of the two groups: group-1 received N-acetylcysteine in nebulized form, and group-2 received salbutamol as a nebulized aerosol. Both groups were then compared regarding their clinical improvement and duration of stay in the hospital. The data obtained was analyzed on the statistical software SPSS version 16. Descriptive statistics were obtained by frequencies and percentages. Chi-square test was applied to find p-value.

Results: A total of 100 patients met the inclusion criteria. The mean age was 3 months. On the first day of treatment, the mean clinical severity score at baseline were 5.38 ± 2.62 in group-1 and 4.68 ± 2.2 in group-2. At day 3 and 5, it was 2.9 ± 1.48 and 3.30 ± 1.77 in group-1 and 0.88 ± 1.08 and 1.90 ± 1.32 in group-2 respectively. The clinical severity score after N-acetylcysteine inhalation therapy was better in group-1 on the third but more so on fifth day after hospital admission. The mean duration of hospitalization was 4.67 ± 2.2 days for the whole population and it differed between the 2 groups: 4.36 ± 1.66 days in group-1 versus 4.98 ± 2.6 days in group-2.

Conclusion: On the basis of improvement in clinical severity score and early discharge from the hospital, N-acetylcysteine was found to be an effective therapy in acute bronchiolitis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acetylcysteine / administration & dosage*
  • Acetylcysteine / adverse effects
  • Acute Disease
  • Administration, Inhalation
  • Albuterol / administration & dosage*
  • Albuterol / adverse effects
  • Antiviral Agents / administration & dosage*
  • Antiviral Agents / adverse effects
  • Bronchiolitis, Viral / drug therapy*
  • Bronchodilator Agents / administration & dosage*
  • Bronchodilator Agents / adverse effects
  • Child
  • Child, Preschool
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Male
  • Nebulizers and Vaporizers
  • Prospective Studies
  • Respiratory Syncytial Virus Infections / complications
  • Respiratory Syncytial Virus Infections / drug therapy
  • Respiratory Syncytial Viruses / isolation & purification
  • Severity of Illness Index
  • Treatment Outcome


  • Antiviral Agents
  • Bronchodilator Agents
  • Albuterol
  • Acetylcysteine