A Comparative Efficacy of Oral Prednisone with Intramuscular Triamcinolone in Acute Exacerbation of Asthma

Corticosteroids are recommended for emergency management of an asthmatic attack.this study was designed to compare the effectiveness of oral and intramuscular steroidon spirometric results in acute asthma.we performed a randomized trial involving 88 adults, aged 15-70 years, with acuteexacerbation of asthma requiring treatment with steroids. all had been treated withstandard bronchodilator regimens and then received oral prednisone, 40 mg/day for 7days, or 40 mg/day intramuscular triamcinolone long acting (la) for 3 days. spirometricvariable and percentage of change to baseline forced vital capacity (fvc) and forcedexpiratory volume in 1 second (fev1) after treatment were calculated.baseline characteristic were comparable in the oral prednisone group (n=44) and inthe intramuscular triamcinolone la groups (n=44). after 7 days of treatment, the mean(sd) fev1 and fvc in both groups improved statistically over baseline values(p<0.001). the median percentage change improvement of fev1 between two treatmentgroups was statistically significant: 68±45.3% vs. 53.4±46.5%, p=0.04) respectively, butfor fvc although improvement with prednisone was better than intramusculartriamcinolone la groups, it was not statistically significant (52.6±40.1% vs. 45.8±39.9%,p=0.43) respectively.we conclude that in adults with acute asthma, oral prednisone is more effective thanintramuscular triamcinolone la in improvement of fev1, but although efficacy of oralprednisone in improvement of fvc is more than intramuscular triamcinolone la group,this effect is not significant.