Summary: For children with moderate to severe acute asthma, treatment with albuterol delivered by metered-dose inhaler (MDI) + spacer may lead to a greater reduction in wheezing and a lower likelihood of hospital admission than treatment with albuterol delivered by nebulizer. In this study, treatment with MDI + spacer was preferred over treatment with nebulizer by approximately 85% of children and parents, and the costs of treatment with MDI + spacer were approximately 65% of the costs of treatment with nebulizer.

http://www.ncbi.nlm.nih.gov/m/pubmed/10753248/

Strength of Recommendation = B

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