Although the number of medications for the treatment of status asthmaticus is relatively limited, strategies for the management of acute asthma vary widely both among and within institutions. The choice of drugs, doses, timing of administration, duration of treatment, and assessment measures are often left to the discretion of individual physicians; plans are often not formulated on the basis of data showing efficacy, but rather on local availability and the experience and preference of physicians. The elimination of treatment that adds cost but not improved quality of care can be an effective strategy to optimize the care of acute asthma.