Azithromycin Shortens Asthma Symptoms in Children

20 Jan Azithromycin Shortens Asthma Symptoms in Children

Posted at 23:37h in Asthma, Author Interviews, Lancet, Pharmacology by Marie Benz MD FAAD

Professor of Pediatrics Hans Bisgaard, MD, DMSc Copenhagen Prospective Studies on Asthma in Childhood Herlev and Gentofte Hospital, University of Copenhagen, Denmark.

Prof. Bisgaard

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MedicalResearch.com Interview with:
Hans Bisgaard, MD, DMSc
Professor of Pediatrics
The Faculty of Health Sciences
University of Copenhagen
Head of the Copenhagen Prospective Studies on Asthma in Childhood
University of Copenhagen and Naestved Hospital

Medical Research: What is the background for this study?

Dr. Bisgaard: Childhood asthma is often preceded by recurrent asthma-like symptoms in relation to airway infections in the first years of life. Bacteria and viruses are equally associated with the risk of episodes of asthma-like symptoms in these children, suggesting antibiotics as a potential treatment for such episodes.

Medical Research: What are the main findings?

Dr. Bisgaard: Our study demonstrates a clinically significant shortening of symptom duration by 63% after intervention. The effect size increased with early initiation of treatment, showing a reduction in episode duration of 83% if treatment was initiated before day 6 of the episode. Azithromycin was effective in shortening the episodes even though no pathogenic bacteria was detected. This study is, to our knowledge, the first randomized trial of azithromycin treatment of acute episodes of asthma-like symptoms in young children with a history of recurrent episodes.

Medical Research: What should clinicians and patients take away from your report?

Dr. Bisgaard: Azithromycin reduced the duration of episodes of asthma-like symptoms in young children, suggesting that this drug could have a role in acute management of exacerbations. Further research is needed to disentangle the inflammatory versus antimicrobial aspects of this relation.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Bisgaard: How the effect of azithromycin compares with narrow spectrum antibiotics and whether any long-term effects are associated with recurrent use need to be investigated. We are keenly aware of the potential ecological issues relating to use of antibiotics in terms of bacterial ecology and resistance. Future research should establish the choice of antimicrobial treatment and criteria for treatment, taking societal aspects into consideration.

MedicalResearch: Is there anything else you would like to add?

Dr. Bisgaard: Our data suggest an effect of azithromycin on acute asthma-like episodes and thereby identify a potential future treatment, but do not provide sufficient evidence to recommend this treatment in current clinical practice.

Citation:

Lancet Respir Med. 2016 Jan;4(1):19-26. doi: 10.1016/S2213-2600(15)00500-7. Epub 2015 Dec 17.

Azithromycin for episodes with asthma-like symptoms in young children aged 1-3 years: a randomised, double-blind, placebo-controlled trial.

Stokholm J¹, Chawes BL², Vissing NH², Bjarnadóttir E¹, Pedersen TM¹, Vinding RK¹, Schoos AM², Wolsk HM², Thorsteinsdóttir S², Hallas HW², Arianto L²,Schjørring S³, Krogfelt KA³, Fischer TK⁴, Pipper CB⁵, Bønnelykke K², Bisgaard H⁶.