Magnesium sulfate for acute asthma in adults: a systematic literature review.

Magnesium sulfate (MgSO(4)) has been considered as an adjunct therapy for severe and life-threatening asthma exacerbation. The literature search was performed using MEDLINE, EMBASE, Cochrane Library and Google Scholar to summarize the current state of knowledge regarding magnesium therapy in acute exacerbation of adult asthma. A total of 16 trials and 4 meta-analyses were identified. As results, intravenous MgSO(4) was beneficial in severe exacerbation, but evidence for nebulized magnesium was insufficient. However, larger trials are required to draw confirmative conclusions on the efficacy. Regarding the safety concern, the risk of major toxicity appears to be very low at usual doses described in the literature. Additionally, results from 4 surveys were examined on the gaps between knowledge and practice, and on the barrier to the use of MgSO(4) at emergency departments. This literature review summarized the up-to-date evidence on the issues regarding the use of MgSO(4) for acute asthma. We expect more studies to be conducted for evidence making in the Asian-Pacific regions.