If recovery is slow, the dosage may be reduced to 6 puffs a day and continued until recovery is complete. If further early systematic treatment is necessary, adrenaline may be given in the acute stage of bronchial spasm and oxygen may be necessary. Treatment of severe cases is very difficult because of tissue damage. Absolute rest and administration of oxygen are fundamental. Expectorants may also be used.
Bronchopneumonia is treated by antibiotics.
Five puffs should be given each hour for the next 10 hours. Systemic therapy is needed even for precautionary treatment during the first 24 hours and should commence as soon as possible with the IV injection of 20 mg of betamethasone or the equivalent dose of another systemic steroid. This dose should be repeated IV or IM every 6 hours for at least the first 24 hours. During the next 5 days, inhalation therapy should be continued but systemic therapy may be reduced based on clinical response and chest x-ray improvement. Antibiotic coverage should be considered with these high doses of steroids in patients predisposed to pulmonary infection complications.