i feel your pain. i actually refuse to take steroids due to the side effects [some which have been permanent] being worse than abpa itself. luckily it hasnt flared up again sice the last dose anyway. as to whether there is a substitue that is equally as effective, there isnt really one. BUT, there are other ways to treat abpa. no matter which route you choose to take, steroids or no steroids, your daughter should be on itraconazole [sporanox], which is an anti fungal. after all, there is no point giving steroids if nothing is being done to actually eradicate the aspergillus in the first place! its like giving pain killers galore to someone with a broken leg but not actually treating the broken leg! with itraconozaole you need to make sure you are on enough of it otherwise its useless and you need regular liver function tests done. its also good to drink a glass of coke with the itraconazole tablet, especially if your daughter is on acid reducing meds, because it absorbs better when the stomach is acidic. some countries/centres actually use nebulised steroids in place of oral steroids. ive heard its not as effective as oral steroids but it still does the job. and when you think about it its much better to have the steroids go directly to the place that needs it the most, the lungs, instead of going to every other organ in the body and causing havoc. there is also alternate day therapy, where people take a double dose 1 day and nothing the next. the theory behind that is on the day you dont take anything, your own adrenal glands are forced to kick in and do its thing, therefore reducing side effects. i have not tried that so i dont know if it really works but anything is worth a try.
