Attacks of asthma in most children are relatively mild, but in a few they are severe and potentially fatal.1 The severity of attacks can be reduced by β-adrenoceptor stimulants, theophylline compounds and sodium cromoglycate, but when these are not effective it may be necessary to give a corticosteroid continuously. For those children who develop a severe exacerbation despite maintenance treatment, or those who get infrequent but often severe attacks that do not respond to bronchodilators, a short high-dose course of a corticosteroid can be given, and many practitioners choose to give this to their patients at home.2 However since no trials of such treatment have been performed the benefit remains unproven.
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