Comparison of racemic albuterol and levalbuterol in the treatment of acute asthma in the ED - 21/08/11
, Stephen Babin, RN dAbstract |
Background |
Acute asthma is often treated with racemic albuterol, a 1:1 mixture of (R)-albuterol and (S)-albuterol. Levalbuterol is the single-isomer agent comprised (R)-albuterol, an active bronchodilator, without any effects of (S)-albuterol.
Objective |
To compare emergency department (ED) admission rates of patients presenting with acute asthma who were treated with either racemic albuterol or levalbuterol.
Setting |
Suburban community teaching hospital.
Design |
Retrospective observational case review.
Methods |
Emergency department patients presenting with acute asthma at 2 different sites were reviewed over 9- and 3-month consecutive periods. Outcome measures included ED hospital admission rate, length of stay, arrival acuity, and treatment costs. Patients were excluded if younger than 1 year or if no treatment of acute asthma was rendered.
Results |
Of the initial 736 consecutive cases, significantly fewer admissions (4.7% vs 15.1%, respectively; P = .0016) were observed in the levalbuterol vs racemic albuterol group. Of the subsequent 186 consecutive cases, significantly fewer admissions were also observed (13.8% vs 28.9%, respectively; P = .021) in the levalbuterol vs racemic albuterol group. Treatment costs were lower with levalbuterol mainly because of a decrease in hospital admissions.
Conclusion |
Levalbuterol treatment in the ED for patients with acute asthma resulted in higher patient discharge rates and may be a cost-effective alternative to racemic albuterol.
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| ☆ | This investigation was not funded by any pharmaceutical company. Partial funding was obtained from Emergency Medical Associates Research Foundation. |
| ☆☆ | Dr Schreck has provided post-study consultative services to the manufacturer of levalbuterol, Sepracor, Inc, by serving on the Sepracor Speakers Bureau. |
Vol 23 - N° 7
P. 842-847 - novembre 2005 Retour au numéro
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