There are no firm guidelines for the treatment of drug-associated ILD and therapy tends to be on an empirical basis. Withdrawal of the drug suspected of causing the ILD is the first step in treatment. For patients in respiratory failure, high-dose methylprednisolone (250 mg four times a day i.v.) for several days is commonly used. If the patient responds, then the dose is reduced (0.5 -1 mg kg À1 day À1 orally) for several weeks before being gradually tapered. For patients in respiratory distress, methylprednisolone (1 mg kg À1 day À1 or 60 mg day À1 ) is commonly used, again with gradual dose reduction. Low-dose methylprednisolone (10 -20 mg) is prescribed for patients with mild radiographical or pulmonary function abnormalities, particularly if oral corticosteroids are contraindicated (White and Stover, 1984; Baughman et al, 1994; American Thoracic Society, 2002) .