Q: How should steroids be used in patients hospitalized with acute asthma exacerbation? What is the proper dosage?
A: Corticosteroids should be given early in the hospital course once insufficient response to inhaled bronchodilators is recognized. The optimal dosage of corticosteroids is still unknown. For initial therapy, doses >100 mg prednisone seem to add no additional benefit. After the initial dose of corticosteroids, 60-80 mg of methylprednisolone equivalent per day appears sufficient. Corticosteroids are then tapered based on patient response and previous corticosteroid history.