[Survey of medical specialists regarding bronchial asthma treatment].
A survey about asthma management was conducted in a group of 300 chest physicians randomized from a list of the whole country. This paper dealt with the questions about treatment in acute asthma and during maintenance therapy in adults and in children older than 6 years. Of the questionnaires mailed, 98 responses were obtained (32.7%)); 71% of the responders were respiratory medicine specialists (RM), 12% RM + Internal Medicine (IM), 6% in RM + Allergy (A), 5% in A, 4% in IM and 2% in IM + A. For the treatment of acute severe episodes 57.5% of the physicians chose nebulized or inhaled beta agonists (IBA) as the first choice for adults and 63.4% for children, parenteral steroids 26.3% in adults and 22.5% in children. For maintenance therapy, the first choice formulation was IBA for adults in 37.6% of the responders and inhaled steroid (IS) in 34.1% of them. In children, 34.7% of the responders choose IBA, 25.3% cromoglicate or nedocromil and 14.7% IS. IBA were prescribed more commonly for treating symptoms, secondly for preventing symptoms and in third place for continuous preventive treatment in adults and in children. The recommendation of IBA for treating and preventing symptoms were more commonly done in children. The average normal daily dose of IS was 297 and 254 micrograms for adults and children, respectively. The average maximal dose was 1176 and 618 micrograms for adults and children, respectively. The recommendation of hyposensitization for allergic asthma was, as mean score of frequency of use (from 0 = never to 3 = always), 0.96 for adults and 1.13 for children. Important drawbacks were detected in the treatment approach. In acute asthma episodes about 40% of the responders did not use IBA as the first choice of treatment. For maintenance treatment IS were rarely used, and their doses were less than the usually recommended by different guidelines. IBA were seldom recommended for prevention or treatment of symptoms. They are used moderately as continuous preventive treatment. Hyposensitization is commonly recommended and more frequently used than in other countries.
Instituto de Investigaciones Neurológicas Raúl Carrea, FLENI, Buenos Aires. raimondi@fleni.org.ar
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Raimondi
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000328:Adult; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D003625:Data Collection; D006801:Humans; D010820:Physicians; D013256:Steroids / Q000627:therapeutic use*
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D013256:Steroids