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Sir.—I read with interest the report by Goldberg et al (Journal 1980;134:596-599) comparing a bolus to continuous infusion of aminophylline in the treatment of asthma. After stating that "the study design appears to favor the demonstration of greater efficacy for the continuous infusion method" and that "it was somewhat surprising that... the difference in response between the two methods was not impressive for most of the children," the authors concluded that "the results of the study suggest that the use of a loading dose followed by a continuous infusion of aminophylline will, on the average, give a better pulmonary response than intermittent injection of the drug, at least at the dosages used herein."
The data only support the conclusion "at the dosages used herein." Only a few of the serum theophylline levels measured during the intermittent therapy are in the optimal therapeutic range of 10 to 20 μg/mL, whereas
MEYER RT. Asthma Treatment. Am J Dis Child. 1981;135(1):84. doi:10.1001/archpedi.1981.02130250070029
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