Methylprednisolone and troleandomycin in treatment of steroid-dependent asthmatic children
R. W. Eitches, G. S. Rachelefsky, R. M. Katz, G. R. Mendoza and S. C. Siegel
Oral methylprednisolone combined with troleandomycin has been reported to
be successful in treating poorly controlled, severe asthma in adults. We
found this drug combination to be effective in treating 11
steroid-dependent children with poorly controlled asthma who were aged 7 to
13 years, for 12 to 28 months. Improvement of clinical and pulmonary
functions was achieved within seven days, with the forced expiratory volume
in 1 s increasing by 38% and the maximal midexpiratory flow rate increasing
by 55% over the baseline value. By one year, the former improved to 98% of
predicted value and the latter, to 79% of predicted value. Compared with
the prior 12 months, patients at this time required fewer emergency visits,
missed fewer days of school, and had fewer hospitalizations. Side effects
included transient-increased cushingoid features, abdominal pain, and liver
enzyme level elevation. Patients showed less evidence of adrenal
suppression.
