Salbutamol as needed is a “killer” and prescribing it for adult asthma equates to medical negligence, a leading European respiratory specialist says, as doctors brace themselves for a somersault in best practice.

Professor Andrew Bush, from the UK’s National Heart and Lung Institute, says “lives would be saved” if short-acting beta-2 agonists (SABAs) were banned from sale worldwide.

In a Lancet Respiratory Medicine commentary, he says axeing SABAs would force patients with mild asthma on to combination inhaled corticosterioid-long acting beta-agonist (ICS-LABA) products, in line with new international recommendations.

His comments follow the results of a 52-week multi-centre trial, which show patients using combination budesonide-formoterol (Symbicort) as needed have fewer severe asthma attacks than those who are on SABAs alone or those on SABAs plus maintenance therapy.