Fuhlbrigge AL, Lemanske, Jr RF, Rasouliyan L, Sorkness CA, Fish JE. Practice patterns for oral corticosteroid burst therapy in the outpatient management of acute asthma exacerbations. Allergy Asthma Proc. 2012 Jan;33(1):82-9. doi: 10.2500/aap.2012.33.3499.


The use of a short course of oral corticosteroids (OCS), or "steroid burst," is standard practice in the outpatient management of acute severe exacerbations of asthma. Despite published guidelines, the actual practice patterns are unknown. A Web-based survey about typical patterns of OCS administration and total steroid burst dose was administered to pulmonologists (n = 150), allergists (n = 150), primary care physicians (n = 153), and pediatricians (n = 150). No predominant dosing regimen was observed, although a fixed single daily dose was the most commonly prescribed regimen (59%). The majority of physicians treating patients greater than or equal to 12 years of age prescribed a total burst dose of less than or equal to 200 mg and essentially all (99.7%) prescribed less than or equal to 600 mg. Among physicians treating younger children, approximately one-quarter prescribed less than or equal to 1 mg/kg per day for 3 days (27.8% for children aged 5-11 years of age and 28.1% for children aged less than 5 years, respectively) and essentially all prescribed less than or equal to 2 mg/kg per day for 10 days (99.8% for children aged 5-11 years and 100% for children aged less than 5 years of age). When prescribing OCS burst therapy for asthma exacerbations, physicians tend to prescribe less than the upper dose recommended in the guidelines; with many physicians prescribing a total steroid burst dose below the lower end of the recommended dose range. Additional study is needed to determine the optimal dose and duration for treating exacerbations of asthma with OCS to minimize both side effects and time to reestablishing asthma control.

Share on: