+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Corticosteroids in acute severe asthma: effectiveness of low doses

Corticosteroids in acute severe asthma: effectiveness of low doses

Thorax 47(8): 584-587

Background: Although the need for corticosteroids in acute severe asthma is well established the appropriate dose is not known. Methods: The response to intravenous hydrocortisone 50 mg (low dose), 100 mg (medium dose), and 500 mg (high dose), administered every six hours for 48 hours and followed by oral prednisone, was compared in patients with acute asthma in a double blind randomized study. After initial emergency treatment with bronchodilators subjects received oral theophylline or intravenous aminophylline and nebulized salbutamol four hourly. Patients were given low, medium, or high doses of intravenous hydrocortisone and then 20, 40, or 60 mg/day respectively of oral prednisone with a reducing regimen over the following 12 days. Beclomethasone diproprionate, 400 .mu.g twice daily by metered dose inhaler, was also started. Peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), and visual analogue dyspnoea scores (VAS) were recorded daily in hospital and PEF and VAS twice daily after discharge for a total of 12 days. Results: The 66 subjects (40 female) who completed the study had a mean (SD) age of 31(14) years. On presentation mean (SD)FEV1% predicted in the low (n = 22), medium (n = 20), and high dose (n = 24) groups was 17(13), 19(12), and 19(11) and after emergency bronchodilator treatment 32(20), 30(12), and 36(13). After 24 hours of treatment the respective postbronchodilator FEV1 % predicted values were 62(22), 62(23), and 65(28) compared with 71(24), 69(22), and 71(24) after 48 hours. No significant difference between the groups was detected. PEF and VAS improved with treatment over the 12 days but was not influenced by steroid dose. Conclusions: Hydrocortisone 50 mg intravenously four times a day for two days followed by low dose oral prednisone is an effective in resolving acute severe asthma as 200 or 500 mg of hydrocortisone followed by higher doses of prednisone.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 007165148

Download citation: RISBibTeXText

PMID: 1412112

DOI: 10.1136/thx.47.8.584

Related references

Optimal doses corticosteroids in acute severe asthma. Journal of Allergy & Clinical Immunology 91(1 PART 2): 164, 1993

Formoterol (Foradil) and medium-high doses of inhaled corticosteroids are more effective than high doses of corticosteroids in moderate-to-severe asthma. Pulmonary Pharmacology & Therapeutics 16(5): 299-306, 2003

Combination regimens of the inhaled preparation ie; salbutamol with corticosteroids proved more effective in relieving severe bronchial asthma than high doses of corticosteroids alone. Chest 118(4 Suppl ): 189S, October, 2000

Should corticosteroids be used in the treatment of acute, severe asthma? II. A case against the use of corticosteroids in acute, severe asthma. PharmacoTherapy 5(6): 331-335, 1985

Should corticosteroids be used in the treatment of acute, severe asthma? I. A case for the use of corticosteroids in acute, severe asthma. PharmacoTherapy 5(6): 327-331, 1985

Treatment of acute asthma. Comparison of the effectiveness of corticosteroids and of a combination of corticosteroids and an adrenergic beta-stimulant. La Nouvelle Presse Medicale 6(45): 4183-4186, 1977

Inhaled corticosteroids may be superior to systemic corticosteroids in children with moderate-to-severe acute asthma. Pediatric Asthma Allergy & Immunology 16(3): 121-128, Fall, 2003

Effects of high doses of inhaled corticosteroids on adrenal function in children with severe persistent asthma. Thorax 48(6): 599-602, 1993

Corticosteroids for acute, severe asthma. Dicp 25(1): 72-79, 1991

Acute myopathy in severe acute asthma treated with intravenously administered corticosteroids. American Review of Respiratory Disease 137(2): 460-463, 1988

Are corticosteroids necessary in the treatment of severe acute asthma?. British Journal of Diseases of the Chest 76(2): 125-129, 1982

Are corticosteroids necessary in the treatment of acute non-severe asthma?. Revista Paulista de Medicina 106(1): 28-34, 1988

Effects of corticosteroids in acute severe asthma. Thorax 47(8): 582-583, 1992

Doses of systemic corticosteroids in hospitalised children with acute asthma: A systematic review. Journal of Paediatrics and Child Health 42(4): 179-183, 2006