Giving Asthmatics Intramuscular Steroids for Preventing Return to the Emergency Department

This study aims to compare the efficacy of a one-time IM dose of dexamethasone versus a 5-day course of prednisone in adult ED patients presenting with asthma exacerbations. This is a randomized, controlled, double-blind, non-inferiority trial conducted at two urban EDs within the Montefiore Health System.

Inclusion Criteria: * Adults ≥18 years old presenting to the ED with an asthma exacerbation * Diagnosed with asthma per International Classification of Diseases, 10th Revision (ICD-10) criteria or by the treating clinician * Discharged from the ED with a primary diagnosis of asthma exacerbation * Initiated systemic corticosteroids during the ED visit * Must be English or Spanish speaking Exclusion Criteria: * Current use of systemic corticosteroids, including Emergency Medical Services (EMS) administration before ED arrival * History of severe adverse reactions to corticosteroids * Heart failure and uncontrolled diabetes (glucose \>300mg/dL in the ED) * Pregnancy or breastfeeding as prednisone is the preferred treatment for asthma in this population * Inability to provide informed consent