A recent study published in the Asian Pacific Journal of Allergy and Immunology aimed to compare the efficacy and safety of nebulized magnesium sulfate (MgSO4) and ipratropium bromide/fenoterol in moderate to severe asthma attacks.This prospective, double-blind, randomized, controlled trial included 33 Thai children in the age-range of 2-15 years, with PRAM score ≥ 4 (moderate to severe asthma exacerbation) despite 3 doses of nebulized salbutamol. Each patient was randomized toreceive either three doses of nebulized MgSO4 or nebulized ipratropium bromide/fenoterol every 30 minutes. The PRAM score was measured at 0, 30, 60, 90, 120 and 240 minutes after the treatment.Overall, 16 patients received nebulized MgSO4 and 17were given nebulized ipratropium bromide/fenoterol. Almost all patients had moderate asthmatic attack. The results revealed no statistically significant difference between the two study groups in the baseline characteristics and PRAM scores at 0, 30, 60, 90, 120, 240 minutes. In addition, the hospital length of stay was equivalentamong two groups; while there were no serious events.The findings exhibited non-inferior outcomes including clinical benefit and safety of nebulized MgSO4 and nebulized ipratropium bromide/fenoterol among children with acute moderate asthmatic attack.