Antibiotics for Asthma?

Antibiotics for Asthma?


The current issue of the prestigious journal New England Journal of Medicine reports on an international clinical trial of the new antibiotic telithromycin (Ketek), which has been found to effectively relieve acute asthma symptoms and improve results of breathing tests.

Do these results mean we should be adding antibiotics to steroids and bronchodilators when managing patients with moderate to severe asthma symptoms? I would say it's too soon to make that move.

Telithromycin belongs to the macrolide class of antibiotics, which also includes the drugs clarithromycin (Biaxin) and erythromycin (ERYC). Studies are now under way to determine whether clarithromycin can improve asthma symptoms and control in the longer run.

As part of that research by the Asthma Clinical Research Network (a consortium funded by the National Heart, Lung and Blood Institute), the researchers will study whether any improvement in asthma symptoms is due to the drug's effect on low-grade infections caused by two bacterial species that have been linked to asthma: chlamydia and mycoplasma.

An alternate explanation for the effectiveness of drugs in this antibiotic class is that they have an anti-inflammatory effect, which may include boosting the effects of steroids taken for asthma by slowing down metabolism. If it turns out that the beneficial effect is due to this mechanism, it wouldn't make sense to prescribe such an antibiotic to boost the effects of steroids. It would be easier and less toxic to give a slightly higher steroid dose.

If you or a family member is plagued by moderate to severe asthma, don't ask for Ketek or another macrolide antibiotic yet. Studies are needed to reveal how these drugs work, and fortunately, these are already under way