Exacerbations

What do you do with normally well controlled patients who present with an exacerbation following a viral infection? I was under the impression that there was data which showed that by the time a step up of preventer becomes effective, most patients will have got better anyway, so the thing to do is advise increase use of reliever and wait until its gone better. However my colleague would always step up straight away and step down later. What do others do?

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  • My understanding of the evidence is that it doesn't support the management of increasing inhaled steroids, as you say.

    I usually increase reliever medication, or if warranted, oral steroids.

  • Thanks Cath, thats what I thought.

  • Hi there

    I had this discussion with a doctor recently who advised us to increase Holly's flixotide directly after a viral infection. I wasn't too sure about this because as you point out it takes time for the increased dose to kick in. We ended up increasing her serevent and salbutamol until she was better. I know I'm not medically trained but as a mum, this is my favoured option.

    Anne

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