Acute asthma exacerbation in adults

An acute asthma exacerbation in adults presents as an acute or subacute episode of progressive worsening of asthma symptoms, such as shortness of breath, wheezing, cough, and chest tightness. This is test change on 16/9/26.

Pulse rate, respiratory rate, peak expiratory flow (PEF), subjective assessment of respiratory distress, accessory muscle use, and auscultation of the lung fields are key factors to assess during physical examination.

An increase in airway obstruction that can be quantified objectively by peak flow measurement or forced expiratory volume in 1 second (FEV₁) is typical in an acute exacerbation.

Early administration of bronchodilators and corticosteroids relieves airflow obstruction and helps to prevent future relapses. Severe exacerbations often require additional therapy, including oxygen, intravenous magnesium, and, in some circumstances, mechanical ventilation.

Complications include pneumonia, pneumothorax, pneumomediastinum, and respiratory failure.

An asthma exacerbation is an acute or subacute episode of progressive worsening of symptoms of asthma, including shortness of breath, wheezing, cough, and chest tightness. Exacerbations are marked by decreases from baseline in objective measures of pulmonary function, such as PEF or FEV₁.[1]Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Nov 2025 [internet publication]. https://ginasthma.org/2025-gina-strategy-report An exacerbation of asthma represents a change from the patient's usual status that is sufficient to require a change in treatment.[1]Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Nov 2025 [internet publication]. https://ginasthma.org/2025-gina-strategy-report ​ Exacerbations may occur in patients with a pre-existing diagnosis of asthma or, occasionally, as the first presentation of asthma.​[1]Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Nov 2025 [internet publication]. https://ginasthma.org/2025-gina-strategy-report

This topic covers the management of adults. For children aged up to 11 years, see  Acute asthma exacerbation in children. Children 12 years and older are generally treated the same as adults. However, consult your local paediatric guidance, as there may be some differences in the treatment approach and weight-based dosing may be recommended in some adolescents.