INFLUENCE OF SPACER DEVICE ON DRUG DELIVERY TO YOUNG CHILDREN WITH ASTHMA

Abstract

Purpose of the Study. To evaluate the effectiveness of three different spacer devices for the delivery of an inhaled corticosteroid in asthmatic children 10 to 25 months of age.

Methods. The three spacers used were: Nebuhaler, Babyspacer, and Aerochamber (only the Aerochamber is available in the United States). Twenty children received in a crossover pattern 200 µg, in a single dose, of budesonide via a spacer and tightly-fitting face mask. A special filter was interposed between the face mask and the infant to catch the inhaled budesonide, which was then measured. In addition, the flow rates generated by the infants were determined as well as the budesonide remaining in the spacers.

Results. Both the Nebuhalen and Babyspacen were convincingly better than the Aenochamben in the amount of active drug as measured in the filter. The investigators felt that the amount deposited on the filter was an indicator of how much would reach the lungs.

Discussion. The Aerochamber had been the spacer of choice of the authors' before the study was completed, so the results were unexpected.

Reviewer's Comments. We have all used spacers to some degree and truly wonder how much medicine the patient really does receive. I feel Drs Agertoft and Pedersen have come up with an excellent way to resolve this dilemma.