Akefeh Ahmadi Afshar - Supervisor, Professor of Allergy and Clinical Immunology, Department of Pediatrics, School of Medicine, Ayatollah Mousavi Hospital Zanjan University of Medical Sciences, Zanjan, Iran
Maryam Rahmati - Medical Doctor, Department of Medicine, Department of Pediatrics, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
Azam Maleki - Advising professor, assistant professor, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan,
Kourosh Kamali - Advising professor, associate professor, Department of Public Health, Faculty of Para medicine and Health, Zanjan University of Medical Sciences, Zanjan Iran

Background: Severe and moderate asthma attacks are among the major causes of children’s visits to emergency departments. Objectives: The present systematic review is conducted to assess the effectiveness of inhaled budesonide on hospitalization and clinical presentations in children with asthma. Methods: A search was conducted on six English databases from ۲۰۰۰ to ۲۰۲۲. Quality assessment was done using Cochrane Collaboration’s tool for Assessing the Risk of Bias, and heterogeneity was assessed using I۲. The risk of bias was calculated using a funnel plot and Begg and Egger tests. The data were analyzed using RevMan ۵, and random effects, the risk ratio and means difference were reported with a ۹۵% confidence interval. Results: Totally, ۱۳۸۰ studies were identified. After the screening, ten studies with a sample size of ۱۸۵۹ were included in the systematic review. The asthma scores were improved following budesonide administration in ۱۰ studies. Compared to the placebo, the effects of budesonide on hospitalization rate were not statistically significant, but they were statistically significant with zero heterogeneity compared to other corticosteroids. Compared to the placebo or oral corticosteroids, there were no significant differences in heart rate, respiratory rate, and oxygen saturation after budesonide administration. Conclusion: The effects of inhaled corticosteroids were similar to other oral corticosteroids and the placebo. Considering the high heterogeneity of the studies, future studies with larger sample sizes and longer follow-ups are recommended.

asthma, corticosteroid, budesonide, randomized controlled trialsdy