acute asthma exacerbation

This patient has an acute asthma exacerbation most likely due to a viral upper respiratory infection.  Several published treatment guidelines recommend the use of systemic corticosteroids for the following:

  • All moderate to severe acute asthma exacerbations (urgent care or emergency room settings)
  • Mild exacerbations (outpatient setting) that have been unresponsive to standard inhaler therapy

Meta-analyses demonstrate that patients treated with a short course of systemic corticosteroids had fewer future exacerbations requiring hospitalization and decreased use of reliever medications.  In addition, patients given systemic corticosteroids within an hour of presentation were significantly less likely to be admitted to the hospital.

The optimal dosage and duration of corticosteroid therapy have not been determined; however, general recommendations are prednisone 40-60 mg daily for 5-7 days.