Asthma - Management of Exacerbations
Routine prescribing of antibiotics for asthma exacerbations is not warranted as most are viral or non-infective.
Consider antibiotics if systemic symptoms are present; follow local antimicrobial guidelines.
Green sputum alone is not diagnostic of bacterial infection and occurs due to inflammation.
Prescribe prednisolone 40-50mg daily for 7-14 days then stop, and advise patient to return if not better.
Only reduce prednisolone dose slowly if patient:
• has received repeated courses (especially if taken for longer than 3 weeks)
• has other factors pre-disposing to adrenal suppression (e.g. Addison’s disease)
Children’s dosing of prenisolone
- 1 month to 11 years: 1-2 mg/kg once daily for up to 3 days (max dose 40mg)
- 12 years to 17 years: 40-50mg daily for at least 5 days
– see BNF for Children for further information.
Rescue packs
Prescribe only on advice of respiratory consultant:
Prednisolone - 5mg tablets, supply 56
Dose - eight tablets daily for seven days
Antibiotics are rarely necessary - follow respiratory specialist advice. Follow local antimicrobial guidelines.
- Ensure patient is clear when and how to use
- Include in written self-management plan
- Advice to notify GP practice when treatment started
- First Line Drugs
- Second Line Drugs
- Specialist Initiated Drugs
- Specialist Only Drugs
- Mixed Status