New guidelines on asthma management

Aim to control symptoms rapidly, with higher initial doses of steroid and earlier use of ß agonists

The British guidelines on the management of asthma first appeared in 1990 in the BMJ.1 2 Two years later revised guidelines, extended to cover asthma in childhood, were distributed to all hospitals and general practitioners in Britain.3 They have come to be widely respected as a clear and practical statement of best practice in the management of asthma. This month sees the publication of a review and a position statement commenting on the guidelines in the light of recent evidence.4

The participants for the latest review were those from the 1993 paper, if they wished to continue, or replacements as needed. Background papers were produced and subsequently published.5 The summary statement was discussed and agreed in 1995, and it is disappointing that publication has been delayed until 1997. The summary statement should be read in conjunction with the 1993 guidelines.

Most of the 1993 advice remains valid, but there are important changes. The new guidelines reiterate the importance of a correct diagnosis and the dangers of escalation of treatment in other …