For children needing continuous nebulisation after a severe asthma attack, preservative-free salbutamol may be safer than solutions containing benzalkonium chloride (BAC), a retrospective study suggests.

US researchers compared outcomes of inpatients at a University of Florida children’s hospital who received continuous nebulised salbutamol 1.5 years before or 1.5 years after the institution’s change in the formulation.

In 2015, the hospital switched from a 0.5mL unit-dose preservative-free formulation for continuous nebulisation to a 20mL dropper bottle containing the BAC preservative, which is known to be able to cause bronchospasm.

As reported in Pediatrics, 477 children (mean age six, 55% boys, 60% African American) were included in the analysis, 236 of whom were given the BAC formulation.