Safety and effectiveness of albuterol solutions with and without benzalkonium chloride when administered by continuous nebulization. (15th November 2018)

• Record Type: Journal Article
• Authors: Orth, Lucas E.; Kelly, Brian J.; Lagasse, Carrie A.; Collins, Shelley W.; Ryan, Matthew F.
• Is Part Of: American journal of health-system pharmacy. Volume 75:Number 22(2019)
• Page Start: 1791
• Page End: 1797
• Publication Date: 2018-11-15
• Subjects: albuterol -- asthma -- benzalkonium chloride -- bronchospasm -- preservatives -- status asthmaticus; Hospital pharmacies -- United States -- Periodicals; 615.1
• DOI: 10.2146/ajhp180154
• Languages: English
• ISSNs: 1079-2082

Abstract

Abstract : Purpose: The results of a study to determine if rates of poor response differ in patients receiving continuous nebulized albuterol (CNA) therapy with or without the preservative benzalkonium chloride are presented. Methods: A retrospective analysis of the records of all patients who received CNA therapy at a large academic medical center from July 2015 to January 2016 was conducted. Data from patient evaluations performed before and after a change to benzalkonium chloride–containing albuterol were collected. The primary outcome was the rate of poor patient response, defined as a composite endpoint. Secondary outcomes included duration of therapy, dosing requirements, and duration of supplemental oxygen therapy. Results: There was no significant difference in rates of poor response between patients exposed ( n = 80) and patients not exposed ( n = 48) to benzalkonium chloride (16% and 17%, respectively; p = 0.95). The cohort not exposed to benzalkonium chloride had a median CNA duration of 7.0 hours, as compared with 10.5 hours for the cohort exposed to benzalkonium chloride, but this difference was not significant ( p = 0.19). There were no significant differences between the benzalkonium chloride–exposed and nonexposed cohorts in the maximum dosing requirement (12.6 mg/hr versus 12.8 mg/hr, p = 0.89) or median duration of supplemental oxygen use (27.5 hours versus 16.5 hours, p = 0.77). Conclusion: A study of hospitalized patients receiving CNA detected no significant difference in the frequency of poor response to therapy between groups receiving benzalkonium chloride–free versus benzalkonium chloride–containing albuterol products.