MODERATE PERSISTENT ASTHMA IN CHILDREN;

COMPARISON OF INHALED BECLOMETHASONE WITH ORAL MONTELUKAST IN THE MANAGEMENT

Abstract

Objective: The objective of this study is to compare the effects of inhaled
beclomethasone with oral montelukast in long term management of moderate persistent asthma
in children. Design: Quasi experimental study. Period: 6 months, from July 20,2007 to January
20, 2008. Settings: Out patient paediatric department at Fauji Foundation hospital, Rawalpindi.
Material and Methods: 8o children between 5-12yrs of age presenting with moderate persistent
asthma, divided in two groups of 40 each. Group A treated with beclomethasone inhaler while
Group B was started on oral montelukast. Drugs effect was recorded on a 2 wkly proforma for 8
weeks. Results: There were 54(67.5%) male and 26(33%) female. Most common triggering
factor seen in 54(67.5%) patients was recent history of respiratory tract infection, exposure to
carpet dust in 43(53.75%), cigarette smoke in 42(52.5%),recent psychological stress in 28(35%) ,
pollen allergy in 26 (32.5%) , pets exposure in 8 (10%) and to mite was noticed in 5(6.25%)
children. Marked improvement was observed in day time cough in group A with 10(25%) patients
being free of cough with inhaler, while 20(50%) showed mild intermittent symptoms. 1(2.5%)
showed mild persistent symptoms. In Group B 3(7.5%) patients were symptom free,
23(57.5%)with mild intermittent and 4(10%) with mild persistant symptoms while 6(15%)
continued to have moderate persistent symptoms. P value was 0.01. Regarding day time
breathlessness, P value was significant of 0.258. Similarly marked improvement was observed in
night symptoms of breathlessness, cough and sleeplessness in both groups. P value was less
than 0.05 in majority of the variables showing statistically significant improvement with inhaled
beclomethasone than with oral montelukast. Conclusions: Inhaled beclom