Double or nothing? Treating exacerbations of asthma.

摘要

Asthma remains a major public health problem with over 300 individuals dying of asthma per year in Australia, a mortality rate which is moderately high by international standards. Whilst mortality is an obvious indicator of the impact of asthma, its impact on areas such as hospital expenditure and days lost from usual activities is also very substantial. Virtually all morbidity and mortality from asthma are due to exacerbations, which are substantially reduced by best current treatment. In particular, both national and international guidelines promote asthma management plans which support self-regulation of the use of inhaled therapy, including increased use of short-acting P2-agonists and doubling of inhaled corticosteroids for mild exacerbations prior to the introduction of oral or parenteral corticosteroids for more severe exacerbations. Consequently, the strategy of doubling inhaled corticosteroid dose in an attempt to avoid escalation of mild-moderate asthma exacerbations has been widely adopted in Australia.