Dr Mike Thomas, a Gloucestershire GP, made the sugges-tion in the wake of a study he led into prescribing patterns.
The study found GPs' classifications of asthma severity did not always correspond to guideline recommendations.
Dr Thomas said there may be good reasons for departing from guidelines, but this should be done only after careful thought and with close monitoring. 'GPs should audit their prescribing to ensure they are following the best evidence,' he said.
The researchers looked at data from the UK General Practice Research Database on children with recorded asthma or recurrent wheezing. They evaluated demographics, disease duration, comorbidities, asthma-related NHS resource use, and dose of medication.
GPs for 635 patients were surveyed retrospectively, classifying asthma severity at the prescription date and describing therapy and use of healthcare for six prior months.
The researchers found inhaled corticosteroid monotherapy was the most common controller therapy at all levels of asthma severity. High-dose inhaled corticosteroid therapy or add-on long-acting beta-2 agonist were often prescribed even in intermittent and mild disease.
Dr Thomas said inhaled steroids were effective and safe at standard doses, but not at high doses. 'GPs should be aware of what guidelines and drug licen-ces say, as they are based on the evidence and will produce the best results,' he said