Treatment algorithm

Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups: see disclaimer

ACUTE

all patients

1st line – avoidance of antigen

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ACUTE
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all patients
1st line – 

avoidance of antigen

Recommended in all patients.

Although there is no reliable information regarding effectiveness, clinically it is a sensible option.

The time it takes for symptoms to reduce is antigen-dependent, environment-dependent, and patient-dependent.

Plus – smoking cessation ± pulmonary rehabilitation ± supplemental oxygen

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ACUTE
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all patients
Plus – 

smoking cessation ± pulmonary rehabilitation ± supplemental oxygen

Treatment recommended for ALL patients in selected patient group

Patients who continue to smoke cigarettes should be counseled to quit.

Many patients will benefit from pulmonary rehabilitation programs to improve their functional status and quality of life.[49][50]​​

Severe hypoxemia (PaO₂ ≤55 mmHg or oxygen saturation ≤89%) at rest or with exertion should be managed with supplemental oxygen. This is strongly recommended by the 2020 American Thoracic Society guideline on home oxygen therapy for adults with chronic lung disease.[51][Evidence C]

Consider – corticosteroid

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ACUTE
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all patients
Consider – 

corticosteroid

Treatment recommended for SOME patients in selected patient group

Indications for corticosteroid treatment include persistent acute symptoms despite avoidance of antigen; moderate to severe respiratory impairment (e.g., hypoxemia, lung function tests); and/or extensive lung involvement on imaging.

Patients with fibrotic HP may require long-term, low-dose corticosteroid therapy. Patients with inflammatory features are more likely to benefit from this treatment.

Primary options

prednisone: 0.5 to 1 mg/kg/day orally, taper dose by 5-10 mg/day every other day for 6 weeks

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Choose a patient group to see our recommendations

Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups. See disclaimer

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