Management of acute asthma in childhood. A randomized evaluation of beta-adrenergic agents.

We examined the efficacy of several beta-adrenergic agents commonly used to treat asthma and evaluated the optimum route of administration. Two hundred and sixty-nine persons aged 5 to 21 years who came to the emergency ward while suffering from acute asthma were treated with either (1) inhalation isoetharine hydrochloride or (2) subcutaneous epinephrine or terbutaline sulfate. Patients were evaluated using clinical scores and pulmonary function tests and were monitored for adverse side effects. Regardless of mode of therapy, the acute attack was either treated successfully, terminated in hospital admission, or required further therapy within 24 hours in a comparable number of patients. Adverse side effects were more common with terbutaline sulfate than with either epinephrine or isoetharine in the doses used. Thus, inhalation of beta-adrenergic agents is as effective as subcutaneous administration in the treatment of acute asthma in childhood.