Montelukast has both anti-inflammatory and bronchodilator properties. Does giving a single dose at the time of an emergency department (ED) visit for an asthma exacerbation improve outcomes compared with standard therapy alone?

One hundred seventeen children who presented to an ED with moderate-to-severe asthma exacerbations defined as a Modified Pulmonary Index Score of ≥9 were randomly assigned to receive either montelukast (n = 60) or placebo (n = 57) in addition to standard therapy, which included nebulized albuterol and ipratropium and oral corticosteroids.

The percentage of children whose Modified Pulmonary Index Score decreased to <9 within 4 hours was no different in the montelukast (55%) and placebo (63%) groups (P = .37). There were no differences in the improvement in lung function or hospitalization rates.

Single-dose oral montelukast added to standard therapy of inhaled bronchodilators and systemic glucocorticoids did not provide additional clinical benefit for children with...

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