Editor, – Thank you for the review of asthma therapy delivery devices (Aust Prescr 2003;26:5-7). This article covered important common sense issues in asthma treatment delivery. As suggested by the author, practical issues of use and patient acceptability dominate the decision between a number of otherwise acceptable drug delivery methods. An additional practical issue, in the experience of many Top End practitioners, is that dry powder devices often do not stay dry enough to function in tropical humid conditions, particularly if the users are not very careful to keep the cap screwed on tightly. For this reason dry powder inhalers are not recommended in the Central Australian Rural Practitioners Association Standard Treatment Manual1for use in the tropical Top End.
Dan Ewald
General Practitioner
Lennox Head, NSW
Editor
Standard Treatment Manual for Health Workers, 4th edition.