In severe asthma presenting with an exacerbation, what should be given to reduce the likelihood of hospitalization?

In severe asthma presenting with an exacerbation, what should be given to reduce the likelihood of hospitalization?

• A. Inhaled beta-agonists alone
• B. Inhaled corticosteroids daily
• C. Oral Prednisolone
• D. IV magnesium sulfate

Answer: (C)

When a severe asthma exacerbation occurs, addressing the underlying airway inflammation with a systemic corticosteroid early on reduces the need for hospital admission. A short course of oral prednisolone (or prednisone) dampens the inflammatory response, improves response to bronchodilators, and decreases relapse after discharge. Dosing is typically about 40–50 mg daily for 5 days in adults. Inhaled beta-agonists are crucial for immediate bronchodilation but don’t sufficiently address inflammation to prevent hospitalization on their own. Daily inhaled corticosteroids are for long-term control, not the acute management of a flare. IV magnesium sulfate can be a helpful adjunct in very severe cases, but systemic steroids have the strongest evidence for reducing hospitalization during an acute exacerbation.

When a severe asthma exacerbation occurs, addressing the underlying airway inflammation with a systemic corticosteroid early on reduces the need for hospital admission. A short course of oral prednisolone (or prednisone) dampens the inflammatory response, improves response to bronchodilators, and decreases relapse after discharge. Dosing is typically about 40–50 mg daily for 5 days in adults.

Inhaled beta-agonists are crucial for immediate bronchodilation but don’t sufficiently address inflammation to prevent hospitalization on their own. Daily inhaled corticosteroids are for long-term control, not the acute management of a flare. IV magnesium sulfate can be a helpful adjunct in very severe cases, but systemic steroids have the strongest evidence for reducing hospitalization during an acute exacerbation.