Local Side Effects of Inhaled Budesonide in Asthmatic Children- A Cross-sectional Study
Introduction: There is scarcity of Paediatric literature regarding local side effects of Inhaled Corticosteroids (ICSs) and available paediatric literature on the subject is old and has shown variable prevalence of these side effects varying from none to 60%. Aim: To evaluate local side effects...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2020-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/14059/45711_CE[Ra1]_F(KM)_PF1(AG_KM)_PFA(KM)_PB(AG_KM)_PN(SL).pdf |
| Summary: | Introduction: There is scarcity of Paediatric literature regarding
local side effects of Inhaled Corticosteroids (ICSs) and available
paediatric literature on the subject is old and has shown variable
prevalence of these side effects varying from none to 60%.
Aim: To evaluate local side effects of inhaled Budesonide in
asthmatic children of ≤12 years.
Materials and Methods: In this cross-sectional study, 250
asthmatic children attending Paediatric chest clinic of a tertiary
care hospital and taking inhaled Budesonide for at least three
months were evaluated for occurrence of local side effects
during preceding one month. Local side effects (dysphonia, sore
throat, cough during inhalation, thirsty feeling after inhalation,
oral ulcers) experienced in preceding month were asked for and
clinical evaluation for oral thrush, perioral dermatitis and tongue
hypertrophy was done at the time of assessment. Information
was collected regarding potential risk factors associated with
occurrence of these side effects. Chi-square test was used to
study the association between qualitative variables. Univariate
and multivariate logistic regression were used to study the
association between local side effects and potential factors
associated with their occurrence.
Results: About 250 asthmatic children aged ≤12 years
(64 children <6 years, 186 children ≥6 years) taking inhaled
budesonide via pressurised Metered Dose Inhaler (pMDI)
were evaluated. Almost half (48.8%) of the enrolled children
experienced at least one local side effect, either daily or
frequently, in the preceding month. Though majority experienced
a single side effect, 21% experienced two or more side effects.
Thirsty feeling after inhalation was the most common reported
side effect experienced by 31.2% children followed by cough
during inhalation, sore throat and dysphonia which were
experienced by 25.2%, 17% and 8% children, respectively.
Perioral dermatitis was found in only one patient while none
of the patients had tongue hypertrophy or oral thrush. On
univariate logistic regression, thirsty feeling after inhalation
was associated with older age (≥6 years) and higher dose of
Budesonide (>400 μg/day). Cough during inhalation was found
to be associated with older age, higher dose of Budesonide,
poor compliance to treatment and incorrect technique of taking
pMDI and sore throat was associated with poor compliance and
incorrect technique. However, on multivariate logistic regression,
only cough during inhalation was found to be associated with
higher dose of Budesonide and poor compliance to treatment.
Conclusion: Local side effects are common in asthmatic children
using ICSs and should be routinely assessed during follow-up
as a part of comprehensive asthma management plan. |
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| ISSN: | 2249-782X 0973-709X |