the effect of oral magnesium sulfate on moderate and severe asthma exacerbation in children referred to pediatrics emergency department: the moderating role of asthma severity

Background: asthma is the most common chronic disease in childhood and a cause of hospitalization. intravenous magnesium sulfate is recommended as a complementary therapy for asthma exacerbation. this study investigates the effect of oral magnesium sulfate on moderate and severe asthma exacerbation in children. methods: this double-blind clinical trial was performed on 40 children, aged 5-12 years old with asthma exacerbation, who referred to pediatric emergency department of quaem hospital in mashhad, iran. patients were randomly assigned into two groups, who received magnesium sulfate (300 mg every 12 hours) or placebo capsules for 5 days. asthma severity score based on siriraj clinical asthma score (scas) contained in the questionnaire was recorded for each patient at 0, 2, 6, and 24 hours after the first visit, and then daily up to 5 days. based on their acas, the patients were divided into three groups by the researcher: a (mild): 0-8, b (moderate): 8-16, c (severe):16-24. results: the mean age of subjects was 8.20 ± 2.49 years, and their mean weight was 26.32 ± 8.65 kg. based on the asthma severity, in the magnesium group, 5 patients were classified in group a, 14 in group b, and 1 in group c; and in the placebo group 8 patients were classified in group a, 8 in group b and 4 in group c .the present study, controlling the effect of weight as a covariate, didn't show a significant effect of oral magnesium sulfate on asthma symptoms in 5-12-year-old children (p=0.15); however, after considering the severity variable as moderator, a minor effect on symptom improvements in b score was revealed. conclusion: administration of oral magnesium sulfate within 5 days, didn't improve asthma exacerbation in 5-12-year-old children. so, more studies with different doses and durations are needed to determine the efficacy of oral magnesium sulfate in asthma exacerbation.