A Retrospective Comparison of Single-Dose versus Tapering-Dose Corticosteroid Therapy in Acute Exacerbations of Bronchial Asthma

Abstract

Background. Bronchial asthma is a long-standing inflammatory disorder of the airways, and systemic corticosteroids continue to be a mainstay in the treatment of acute exacerbations. What remains unsettled in everyday practice is whether a short fixed course works better than a dose that is gradually reduced, particularly with methylprednisolone (MP).

Objective. We set out to compare the clinical course and tolerability of single-dose MP against a tapering-dose MP schedule in adults admitted with asthma exacerbations, and to see how patient profiles differed between the two approaches.

Methods. This was a hospital-based, retrospective, observational study of 100 adult patients managed at Erode Medical Centre, Erode, over a three-month window. Half of the patients had received a single dose of MP and the other half a tapering schedule spread over 5–14 days. Case records were reviewed for demographics, admission vital signs (SpO₂, pulse rate, respiratory rate and blood pressure), the duration of the acute episode, steroid dosing and the medicines used alongside MP. Changes within each group were examined using a paired t-test.

Results. Most patients were above 50 years of age. People on the single-dose schedule generally went home sooner, whereas those on a tapering schedule were more often already on maintenance therapy and tended to arrive with lower oxygen saturation and higher respiratory rates – markers of a more troublesome episode. Tracking the weekly tapering data, symptom control was largely achieved by the second week and was essentially complete by the fifth.

Conclusion. A single dose of MP appears well suited to rapid relief in milder acute episodes, while a tapering course fits patients whose disease is more severe and who need inflammation brought down slowly. Whichever route is chosen, close watch on cardiovascular and respiratory parameters matters.