Abstract

Objective: To determine the effectiveness of single intramuscular (IM) methylprednisolone in the treatment of acute asthma exacerbation following discharge from the emergency department (ED).
Methodology: This quasi-experimental study was carried out at the ED of The Indus Hospital Karachi, Pakistan, from July 2024 to December 2024. The inclusion criteria were patients of either gender aged 18 to 80 years presenting with acute asthma exacerbation, and stable enough to be discharged. Patients were initially managed in the ED following standard treatment protocols. Patients who were discharged with clinically stable status were given IM methylprednisolone 160 mg at the time of discharge along with inhaled corticosteroid long-acting beta agonist, montelukast 10 mg once daily, with inhaled bronchodilators on an as-needed basis. The effectiveness of the treatment was marked when there was an absence of relapse within 10 days of treatment.
Results: Out of 134 patients, 73 (54.5%) were males. Mean age was 35.22±11.94 years. Mean duration of diagnosis, and the duration of treatment were 10.53±9.97 years and 2.55±4.25 years, respectively. In 100 (74.6%) patients, a single dose of IM methylprednisolone was found to be effective, while 34 (25.4%) had relapse. The relapse was significantly associated with the presence of comorbidities (29.4% vs. 12.0%, p=0.018).
Conclusion: A single-dose IM methylprednisolone administered at the ED discharge appears to be a viable therapeutic alternative to a course of oral methylprednisolone.

Key words: Asthma, emergency department, intramuscular, respiratory illness, methylprednisolone.