Question of the day

A 16-year-old boy presents in the emergency department (ED) with an acute exacerbation of bronchial asthma and receives nebulized albuterol and 60 mg of prednisone, after which he feels better. He is discharged from the ED after four hours with a prescription of 60mg prednisone daily. He contacts you after six days and asks if he can stop using prednisone because he now feels completely normal. What is the best response to this patient's question?

A. He needs to taper prednisone use over 2months.
B. Prednisone can be discontinued rapidly.
C. Prednisone should be switched to hydrocortisone, and then gradually tapered.
D. He should start taking prednisone on alternate days and then taper it very gradually.
E. Prednisone can be rapidly tapered; however, he will require stress doses of glucocorticoids during the next three months if he develops any infection.

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