Duration of systemic corticosteroids in the treatment of asthma exacerbation; a randomized study

Intern Med. 2000 Oct;39(10):794-7. doi: 10.2169/internalmedicine.39.794.


Objective: To determine an appropriate duration for a short course of oral steroids in cases of asthma exacerbations.

Setting: A 1,000 bed city hospital in Kobe, Japan.

Patients: 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).

Outcome measures: 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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acute Disease
  • Administration, Oral
  • Asthma / drug therapy*
  • Female
  • Glucocorticoids / administration & dosage*
  • Hospitalization
  • Humans
  • Infusions, Intravenous
  • Male
  • Methylprednisolone / administration & dosage*
  • Middle Aged
  • Peak Expiratory Flow Rate
  • Prednisolone / administration & dosage*
  • Time Factors


  • Glucocorticoids
  • Prednisolone
  • Methylprednisolone