Efficacy of bronchodilators administered by nebulizers versus spacer devices in infants with acute wheezing

Pediatr Pulmonol. 1998 Nov;26(5):344-8. doi: 10.1002/(sici)1099-0496(199811)26:5<344::aid-ppul7>3.0.co;2-f.


The aim of this study was to compare the response of infants with acute wheezing to treatments with inhaled terbutaline when administered by nebulizer or by metered-dose inhaler and spacer device (MDI-spacer). Thirty-four infants between the ages of 1 and 24 months who were seen in our emergency department for acute wheezing were studied in a double-blind, randomized trial. The participants received two treatments of terbutaline at 20-min intervals, either by a nebulizer (2 mg/dose in 2.8 mL of 0.9% saline solution) or by an MDI-spacer device (0.5 mg/dose). The outcome measure was a clinical score, based on respiratory rate, degree of wheezing, retractions, degree of cyanosis, color, and pulse oximetry data measured before treatment, 20 min after the first treatment, and again 20 min after the second treatment. There was no difference in the rate of improvement in the clinical score between infants who received terbutaline by nebulizer and those who received it by MDI-spacer. We conclude that MDI-spacers and nebulizers are equally effective means of delivering beta-2 agonists to infants and small children with acute wheezing.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acute Disease
  • Adrenergic beta-Agonists / administration & dosage*
  • Aerosols
  • Bronchodilator Agents / administration & dosage*
  • Double-Blind Method
  • Drug Delivery Systems*
  • Female
  • Humans
  • Infant
  • Male
  • Nebulizers and Vaporizers*
  • Normal Distribution
  • Respiratory Sounds / drug effects*
  • Statistics, Nonparametric
  • Terbutaline / administration & dosage*


  • Adrenergic beta-Agonists
  • Aerosols
  • Bronchodilator Agents
  • Terbutaline