Oral versus intravenous steroids in acute exacerbation of asthma--randomized controlled study

Use of corticosteroids in asthma is a must however the route of administration of steroid in acute exacerbation is a matter of debate. Intravenous steroids used very frequently in clinical practice may not offer any advantage over oral steroids.

To compare to the efficacy of oral vs intravenous steroids in adults admitted with acute exacerbation of bronchial asthma.

Adults admitted to hospital with acute exacerbation of asthma were randomized to receive oral prednisolone 100 mg once daily or hydrocortisone 100 mg i.v. 6 hourly for 72 hrs following admission. All patients concurrently received inhaled corticosteroids and bronchodilators. Improvements in peak expiratory flow rate (PEF) from baseline were compared for 72 hrs.

A total of 65 patients were randomized, 34 received oral prednisolone and 31 received intravenous hydrocortisone. Both groups were matched at baseline for age (40 +/- 13.11 vs 44 +/- 16.23, p 0.27) and percentage prediction both pre (20.11% +/- 6.17 vs 20.58% +/- 4.78, p 0.73) and post bronchodilator (24.35% +/- 5.43 vs 25.38% +/- 5.01, p 0.43). After 72 hrs both groups had improvement in PEF which was statistically insignificant (53.23% +/- 9.54 vs 55.87% +/- 10.34, p 0.28).

Corticosteroids administered orally and IV had similar efficacy in the treatment of adults hospitalized with acute exacerbation of bronchial asthma.