Optimizing short-acting β2-agonist therapy in acute asthma exacerbations: A comprehensive analysis of clinical predictors

Faris Azhar; Nur Ahmad Tabri; Pendrik Tandean; Syakib Bakri; Andi Fachruddin Benyamin; Andi Alfiann  Zainuddin

doi:10.23750/abm.2026.18493

Optimizing short-acting β2-agonist therapy in acute asthma exacerbations: A comprehensive analysis of clinical predictors

Authors

Faris Azhar Hasanuddin University
Nur Ahmad Tabri Hasanuddin University
Pendrik Tandean Hasanuddin University
Syakib Bakri Hasanuddin University
Andi Fachruddin Benyamin Hasanuddin University
Andi Alfiann Zainuddin Hasanuddin University

Keywords:

Asthma exacerbation, Respiratory infections, Medication adherence, Inhaled corticosteroids (ICS), Bronchodilator response

Abstract

Introduction: Asthma is a chronic respiratory disease marked by airway inflammation and narrowing, leading to acute exacerbations. Effective management, including the use of short-acting β2-agonists (SABA), is crucial for symptom control. Factors like inhaled corticosteroid (ICS) adherence, exacerbation severity, and respiratory infections may influence SABA effectiveness. This study explores these clinical predictors in managing acute asthma exacerbations.

Materials and Methods: A cross-sectional study was conducted at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia, with 103 adult asthma patients. Demographic, clinical data, asthma control status, peak expiratory flow (PEF), and oxygen saturation (SpO₂) before and after SABA administration were collected. ICS adherence, exacerbation severity, and respiratory infection status were also evaluated. Paired t-tests and chi-square tests were used for statistical analysis.

Results: Significant improvements in SpO₂ (from 91.2% to 97.0%) and PEF (from 250.7 L/min to 331.6 L/min) were observed after SABA treatment. ICS adherence was a significant factor influencing treatment outcomes, with adherent patients showing better responses. Respiratory infections negatively impacted exacerbation resolution. Exacerbation severity and obesity lost significance after adjusting for ICS adherence and infections.

Discussion: ICS adherence was the primary factor influencing SABA response. Respiratory infections worsened outcomes by increasing airway inflammation, reducing bronchodilator efficacy. Exacerbation severity and obesity were less predictive when adjusted for ICS adherence and infection status.

Conclusion: Optimizing ICS adherence and controlling respiratory infections are essential to improving SABA effectiveness in acute asthma exacerbations. A comprehensive strategy addressing these factors will enhance treatment outcomes.

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