In this trial of 403 patients with asthma, during times of deteriorating peak flows (decline of 15% for 2 days, or 30% for 1 day), they were randomized to a quadrupling of the inhaled steroid dose, or same steroid dose inhaler. Of the 94 patients who “escalated” their inhalers, the intervention group was significantly less likely to require oral steroids (21% vs 50%). Quadrupling inhaled steroid dosing during peak flow declines may reduce the need for oral steroids (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.