The term eosinophilic bronchitis is reserved for patients who again respond to anti-asthma medication but do not exhibit either bronchoconstriction or bronchial hyperresponsiveness. As the term implies sputum examination reveals eosinophils. Whether eosinophilic bronchitis represents a separate disease or is part of a spectrum of asthma is hotly debated and obviously depends on which definition of asthma is used. Patients with eosinophilic bronchitis may be relatively resistant to anti-asthma therapy, only responding to high doses of parenteral steroids or more severe immunosuppression. Attempting to control the disease is important since a proportion of these patients do on to develop fixed airflow obstruction or bronchiectasis.
Even if you have to take steroid tablets for a few weeks or months, this doesn’t necessarily mean you’ll always need them - the aim is to stop the tablets altogether, if possible. Your healthcare professional will consider assessing you for other treatments such as bronchial thermoplasty , Xolair and other medicines in the new class of ‘mab’ drugs with you – these treatments can stop you needing to take steroid tablets so often, and at such high doses. If your asthma’s controlled, you’ll be gradually taken off the tablets. You should never stop taking them suddenly as your asthma symptoms may get worse.
Inhaled Steroids (such as Flovent, Pulmicort, and Qvar): Inhaled steroids can be safely given daily for asthma maintenance control. Because the medication is only going to the lungs (where it is needed) and not to the rest of the body, none of the long-term side effects of oral steroids are experienced. There have been exhaustive studies demonstrating that inhaled steroids given daily are safe and effective, and are considered first line therapy for asthma maintenance. These medications generally take a week or more to reach maximal effectiveness. One should NEVER attempt to use these medications in place of a rescue inhaler for acute symptoms. Because these medications work slowly, we will often start patients on a 3-7 day oral steroid "burst." When the oral steroid is finished, we will often then start an inhaled steroid to safely continue daily anti-inflammatory maintenance therapy.