Case: 54 year old female admitted to ICU with severe exacerbation of asthma but responded pretty well to intravenous glucocorticoids and symptoms resolved completely within 24 hours. How long should steroids be continued?
Answer: 5 to 10 days
Intravenous glucocorticoids should be converted whenever possible to oral form and should be continued for at least about a week, despite resolution of the symptoms. This prevents the recurrence of another exacerbation within next 2 weeks and found to be more effective than a day or two of treatment. Oral form has same efficacy and same bioavailability and is quickly absorbed, and there is no reason to continue IV steroid if patient can tolerate oral prednisone.
National Asthma Education and Prevention Program: Expert Panel Report III: Guidelines for the diagnosis and management of asthma. Bethesda, MD. National Heart, Lung, and Blood Institute, 2007. (NIH publication no. 08-4051)