Spacer devices in the treatment of asthmaBMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7087.1061 (Published 12 April 1997) Cite this as: BMJ 1997;314:1061
All rapid responses
The Editor- Spacer devices reduce the problems of poor inhaler
technique with metered dose inhalers, largely eliminate oral absorption of
inhaled corticosteroids and have been shown to be as effective as
nebulisers in the treatment of acute severe asthma. However, in
developing countries, commercially produced spacers are generally
unavailable or too costly.
In a recent study, authors found that a home-made spacer (modified
500ml plastic cold drink bottle) produces greater pulmonary aerosol
deposition then a conventional small volume spacer. I never prescribe
metered dose inhalers without a spacer device. As some of these patients
are not in a position to purchase spacers, I, then recommend home-made
spacer(mineral water bottle), as this is freely available in India. I,
discourage my patients to use inhalers directly as most of the patients
fail to coordinate actuation and inhalation.
However, owing to their size, spacers are inconvenient to carry, so
dry powder inhaler (DPI) are recommended as the next best device for the
treatment of asthma. I, strongly feel that use of home-made spacers should
be incorporated into the guidelines for the asthma management in
1. O'Callaghan C, Barry P. Spacer devices in the treatment of asthma.
2. Zar HJ, Weinberg EG, Binns HJ, Gallie F, Mann MD. Lung deposition of
aerosol – a comparison of different spacers. Arch Dis Child 2000;82:495-
Competing interests: No competing interests