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

J Assoc Physicians India. 2011 Oct;59:621-3.

Abstract

Background: 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.

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

Methods: 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.

Results: 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).

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

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acute Disease
  • Administration, Oral
  • Adult
  • Aged
  • Albuterol / administration & dosage
  • Anti-Inflammatory Agents / administration & dosage*
  • Asthma / drug therapy*
  • Bronchodilator Agents / administration & dosage
  • Drug Administration Schedule
  • Female
  • Glucocorticoids / administration & dosage*
  • Hospitalization
  • Humans
  • Hydrocortisone / administration & dosage*
  • Injections, Intravenous
  • Male
  • Middle Aged
  • Peak Expiratory Flow Rate / drug effects
  • Prednisolone / administration & dosage*
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Bronchodilator Agents
  • Glucocorticoids
  • Prednisolone
  • Albuterol
  • Hydrocortisone