CLINICAL EFFICACY OF NEBULIZED BUDESONIDE IN ACUTE EXACERBATION OF COPD

INTRODUCTION: Systemic corticosteroids are routinely used for the treatment of acute exacerbation of COPD (AECOPD). Preliminary studies have demonstrated that nebulised budesonide to be as efficacious as parental steroids in AECOPD. OBJECTIVES: To evaluate the clinical efficacy of nebulised budesonide with in AECOPD in comparison with parental steroids. MATERIALS AND METHODS: Patient's with AECOPD were included in the study and divided into two groups randomly. Control group who were given parental steroids and Study group received budesonide by nebulisation (2 mg every 12 hrly) for 5 days. These patients were assessed every 12 hrly from H0 to H72, day 5 and at discharge. The outcome variables studied were FVC, FEV1, PEFR, dyspnea score, spO2 and SGRQ score. Both groups received standard treatment i.e. oxygen, salbutamol plus ipratropium by nebulisation and parental antibiotics during study period. RESULTS: A total of 125 patients were included in the study: 65 in study group and 60 in control group. The baseline FEV1, FVC and PEFR were comparable in both groups. The mean improvement in FEV1, FVC and PEFR after 24 hrs, 72 hrs and day 5 were non-significantly increased in both the groups. Similarly, improvements in oxygen saturation and dyspnea grade at day 5 showed no significance between the two groups. Patients in the study group showed better improvement in SGRQ score as compared to control group. Mean duration of hospitalization was less in study group as compared to control group. CONCLUSION: Nebulised budesonide was equally as efficacious as parental steroids in AECOPD. Nebulised budesonide group had reduced duration of hospitalization and showed better improvement in SGRQ score as compared to control group.