Duration of systemic corticosteroids in the treatment of asthma exacerbation; a randomized study.
OBJECTIVE
To determine an appropriate duration for a short course of oral steroids in cases of asthma exacerbations.


METHODS
A 1,000 bed city hospital in Kobe, Japan.


METHODS
Patients with asthma exacerbations who needed hospital admission.


METHODS
Following an initial treatment with a 3-day course of intravenous methylprednisolone, patients were allocated to either a 1-week (1 W) or a 2-week (2 W) course of oral prednisolone (PSL, 0.5 mg/kg).


METHODS
Peak expiratory flow rate (PEF) and rate of unscheduled hospital visits and readmission.


RESULTS
Twenty patients were enrolled (10 in 1 W, 10 in 2 W). Mean PEF just before starting oral PSL in 1 W and 2 W were 51 and 58% of each patient's best value. PEF was significantly improved and to a similar degree over the course of time in both 1 W and 2 W. The frequency of unexpected hospital visits during a 3-month period after discharge was similar (2 in 1 W and 2 in 2 W). No readmission occurred during the same period.


CONCLUSIONS
Because both the 1-week and the 2-week course of oral PSL were equally effective in the treatment of asthma exacerbations, 1 week may be appropriate as the maximum duration of a short rescue course of oral steroids.
Hasegawa
T
T
Department of Pulmonary Medicine, Kobe City General Hospital, Kobe.
Ishihara
K
K
Takakura
S
S
Fujii
H
H
Nishimura
T
T
Okazaki
M
M
Katakami
N
N
Umeda
B
B
D000208:Acute Disease; D000284:Administration, Oral; D001249:Asthma / Q000188:drug therapy*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006760:Hospitalization; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D011239:Prednisolone / Q000008:administration & dosage*; D013997:Time Factors
D005938:Glucocorticoids; D011239:Prednisolone; D008775:Methylprednisolone