Using a metered-dose albuterol inhaler with a holding chamber attached to it and increasing the number of puffs to treat breathing difficulties works as well as the nebulizer breathing treatment doctors typically prescribe, studies conducted at UF more than 10 years ago show. It also causes fewer side effects in children, studies conducted elsewhere have shown.
Yet doctors and respiratory therapists across the country have been slow to adopt the newer method, even at the hospital where many UF faculty practice, according to a report published this month in the American Journal of Health-System Pharmacy.
A policy implemented last year at Shands at UF medical center, however, increased use of the inhaler and holding chamber method by 53 percent in the intensive care unit and has given researchers hope that more doctors and respiratory therapists will convert to the newer technique.
"Most doctors and patients misbelieve that a nebulizer is more effective than an inhaler," said Leslie Hendeles, a UF professor of pharmacy and pediatrics and the lead author of the report. "There's no difference in any outcome measure except in young children."
Young children, Hendeles said, actually fare better with an inhaler and holding chamber, also called a spacer, than they do with the nebulizer treatment and suffer fewer side effects, such as rapid heartbeat.
Children under 5 who used an inhaler with a spacer were admitted to the hospital less often and made greater improvements than those who used a nebulizer, likely because they receive more medication into their lungs in a shorter amount of time, a study released in the Journal of Pediatrics last year states.