Introduction Despite the evidence supporting the use of intravenous Magnesium Sulfate (MS) in acute asthma; this drug continues being considered as the second line in pediatric acute asthma exacerbations. This study aimed to evaluate the cost-effectiveness of the MS in acute asthma. Methods A decision tree model was used to estimate the Cost-utility study that compared MS versus standard treatment (control group) in an infant with acute asthma in the emergency setting. Cost data were obtained from a retrospective study on asthma from tertiary centers in Rionegro, Colombia, while utilities were collected from the literature. The analysis was carried out from a societal perspective. Results The model showed that MS for treating pediatric patient with acute asthma, was associated with lower total cost than standard therapy (US $1149 vs US $1598 average cost per patient), and higher QALYs ( 0.60 vs 0.52 average per patient); showing dominance. the probabilty that MS provides a more cost-effective use of resources compared with standard therapy exceeds 99% for all willingness to pay thresholds Conclusion MS in emergency settings was cost-effective for the hospital treatment of an infant with asthma moderate or severe. Our study provides evidence that should be used by decision-makers to improve clinical practice guidelines and should be replicated to validate their results in other middle-income countries.

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Introduction The risk stratification of infants presenting to the emergency department with bronchiolitis who are at risk for receiving airway support during their hospital stay has been insufficiently studied. The aim of this study was to determine the clinical predictors of hospitalization with airway support ("escalated care") among infants with recurrent wheezing evaluated in the emergency department Methods: We conducted a retrospective cohort study in infants with one or more wheezing episode, younger than two years of age in tertiary centers in Rionegro, Colombia. The primary outcome measure was escalated care defined as hospitalization plus any airway support. A multivariate logistic regression model was performed to estimate predictors of escalated care. To assess discrimination and calibration, area-under-the-curve (AUC) and calibration plots were calculated. Results A total of 665 cases were included and 85 infants received escalated care. The variables included risk score for escalated care within 5 days of admission to the emergency room including prematurity, poor feeding, nasal flaring and/or grunting, and previous wheezing episodes requiring hospitalization, The model has a high specificity (99.6%) with acceptable AUC of 0.70 (CI 95% 0.60-0.74). Conclusion: A clinical risk score was created based on the odds ratio of each of the identified variables, which appears to be useful for estimating the absolute risk of escalated care within 5 days of admission to the ED. However, external validation is required before this clinical score is applied in general practice in any ED setting