oa African Journal of Thoracic and Critical Care Medicine - Asthma admission rates and patterns of salbutamol and inhaled corticosteroid prescribing

Volume 25 Number 2
  • ISSN : 2617-0191
  • E-ISSN: 2617-0205



Increased use of short-acting beta agonists (SABA) and underuse of inhaled corticosteroids (ICS) among asthmatics have been shown to be associated with increased exacerbations and mortality. SABA are potent bronchodilators and are associated with quick relief of symptoms when used during exacerbations; however, there is no suppression of the underlying inflammation. The overuse of SABA is related to the development of airway smooth-muscle hyperresponsiveness. The newly published GINA document recommends the use of as-needed, low-dose ICS/formoterol combination as step 1 or the use of an ICS every time a SABA is used. This new guideline will help reduce the unopposed use of SABA, which only controls the symptoms without any control on the underlying inflammation causing the exacerbations. The SYGMA 1 trial showed that the balanced use of beta-agonists and ICS as-needed therapy provides superior asthma symptom control and reduction in exacerbations when compared with SABA use in mild asthmatics.[1] One should remember, however, that the authors conceded that regular ICS use was superior to as-needed ICS.

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