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Safety and Effectiveness of Albuterol Solutions With and Without Benzalkonium Chloride When Administered by Continuous Nebulization

Lucas E Orth, Brian J Kelly, Carrie A Lagasse, Shelley W Collins, Matthew F Ryan

Am J Health Syst Pharm. 2018 Nov 15;75(22):1791-1797.

PMID: 30282664

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.

Chemicals Related in the Paper:

Catalog Number Product Name Structure CAS Number Price
CS3104737 Benzalkonium Chloride Benzalkonium Chloride Price
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