Intramuscular triamcinolone for difficult asthma

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Abstract
We treated a selected group of children attending a difficult asthma clinic with intramuscular triamcinolone acetonide. This study retrospectively reviews markers of asthma severity in those who received one or more monthly doses for three periods: 1) 3 months preceding the first injection (pretreatment), 2) from the first injection to 1 month after the last injection (treatment period), and 3) 3 months after the treatment period (follow‐up period). Severity markers during the treatment and follow‐up periods were compared with the pretreatment period by paired t‐test. Five children (5–13 years old) received a single dose, and 8 children (12–15 years old) received multiple doses. Multiple doses of triamcinolone (n = 3–5) were associated with a fall in the number of asthma exacerbations (P < 0.01) and hospital admissions (P < 0.01) in both the treatment and follow‐up periods. A single dose reduced exacerbations (P < 0.05, treatment vs. pretreatment) but not hospital admissions. We conclude that intramuscular triamcinolone is a useful short‐term therapy in difficult asthma. Whether its efficacy is due to improved compliance, or an improved anti‐inflammatory profile compared with oral steroids, remains unclear.