Comparison of efficacy of salbutamol and sodium cromoglycate in the prevention of ticarcillin-induced bronchoconstriction

Abstract

Nebulized ticarcillin can cause bronchoconstriction in children with cystic fibrosis (CF). We assessed whether pretreatment with salbutamol or sodium cromoglycate (SCG) would prevent this side-effect using a randomized, double-blind, placebo-controlled design. Fifteen children with CF received pretreatments of saline, SCG, or salbutamol, in random order, one on each day. Baseline lung function was measured before and after pretreatment, and after ticarcillin nebulization. On the control day (saline pretreatment), ticarcillin caused a reduction in forced expiratory volume in one second (FEV1), which was maximal 10 minutes after receiving the aerosol and persisted for 120 minutes. The mean maximal fall in FEV1 was 9%. Pretreatment with salbutamol abolished the fall in FEV1 seen with ticarcillin at all time points. Pretreatment with SCG diminished the maximal fall in FEV1 at 10 minutes (mean, 4%) and resulted in the FEV1 returning to baseline within 120 minutes. These data suggest that pretreatment with salbutamol is more effective in preventing ticarcillin-induced bronchoconstriction in the doses used in routine clinical practice, than it is with SCG.