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Delivery of a β2 agonist by metered dose inhaler with a bottle spacer was equivalent to delivery by conventional spacer in young children with acute lower airway obstruction

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Q In young children with acute lower airway obstruction, is response to bronchodilator treatment given using a metered dose inhaler (MDI) with a bottle spacer equivalent to that given using a conventional spacer?


Embedded ImageDesign:

randomised controlled equivalence trial.

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded ({healthcare providers, data collectors},* and clinical outcome assessors).

Embedded ImageFollow up period:

after completion of 3 bronchodilator treatments.

Embedded ImageSetting:

a children’s hospital in Cape Town, South Africa.

Embedded ImagePatients:

400 children aged 2 months to 5 years (median age 12 mo, 39% boys) who presented with clinical signs of acute lower airway obstruction (expiratory wheeze on auscultation or hyperinflation of the chest) and had cough or difficulty breathing within the previous 5 days. Exclusion criteria were bronchodilator use in the previous 4 hours, underlying cardiac or chronic pulmonary disease (other than asthma), stridor, or …

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  • * Information provided by author.

  • For correspondence: Professor H Zar, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa. hzar{at}

  • Sources of funding: World Health Organization and Allergy Society of South Africa.