Antibiotic may speed recovery from asthma attacks
13 April 2006

An antibiotic could be effective in helping people who have been admitted to hospital with an asthma attack to recover more quickly, suggests new research.

Scientists studied the effects of the antibiotic, telithromycin, on a group of 278 adults with asthma who had received emergency care for an asthma attack 24 hours previously. Half of the group were given telithromycin for ten days, and half received a placebo, in the double blind study. Patients recorded their asthma symptoms daily, as well as their peak flow rates.

The researchers found that those people who had been given the antibiotic showed a significantly faster improvement in asthma symptoms compared to those taking the placebo, recovering on average three days more quickly than the others. They found no significant difference in peak flow scores between the two groups however.

The research team, drawn from universities around the world, was led by Professor Sebastian Johnson, at Imperial College London, as part of the TELICAST study, which is looking at Telithromycin, Chlamydophila (a type of bacteria) and asthma. The TELICAST project is investigating the possibility that the presence of this bacteria may contribute towards the exacerbation of asthma symptoms: indeed, in this latest study the scientists found the presence of the bacteria C Pneumoniae and M Pneumoniae in 61% of participants.

'Traditionally antibiotics have not proven effective in treating asthma attacks, but this development could open up a whole new area of research in the treatment of asthma,' said Professor Johnston. 'Although we're not sure about the exact mechanism which caused this antibiotic to be effective, this study indicates it does clearly have a beneficial effect. We still need further trials to confirm these results, to investigate the mechanisms of action of this treatment, to see if the same benefits are seen with other related antibiotics and to see which patients are most likely to benefit.'

Asthma UK's Chief Medical Adviser Professor Martyn Partridge welcomed the research: 'This is an extremely important study, not because it should influence clinical practice today but because it raises some important research questions about the mechanism of acute attacks of asthma. The infectious agents C Pneumoniae and M Pneumoniae have been implicated before in the worsening of asthma and this study confirms that and suggests that an antibiotic which is active against those bacteria may be beneficial. What we don't know is whether this is a traditional antibiotic effect or whether this antibiotic has some other anti-inflammatory as opposed to anti-infective effect.

'What we need to remember is that the ability of any infection to make asthma worse probably reflects the fact that somebody's asthma is not fully controlled and regular use of inhaled anti-inflammatory treatments remain the mainstay of therapy and the use of antibiotics for worsening asthma is not yet clinically indicated,' he concluded.

The study is published in the New England Journal of Medicine.