This article is a small piece of mind intended to scrutinize the international asthma guidelines with a sprinkle of subtle criticism toward standard guidelines. As aspiring doctors, we must not always merely adopt international standards, but always stay armed with our knowledge and regional experience to improve, innovate, and revolutionize them to reach utmost efficiency and productivity. The aim of this work is to review old national and international clinical judgment and the recent guidelines of asthma management in an attempt to look at an alternate view on asthmamedications. The article concludes that, in the context of escalation and de-escalation therapies for asthma, one should consider independent future risk factors in asthma control, based on clustering of asthma phenotypes and rather than upon patients' symptoms.
