There could be a new treatment for the millions of Americans suffering from asthma. A group of antibiotics and one in particular, has been shown to help decrease the severity of an asthma exacerbation.
Make no mistake; asthma is one of the most common chronic conditions in the United States. It affects around 20 million Americans and causes nearly two million emergency department visits each year. So anything that can lessen the severity of asthma exacerbations would be welcome. It appears antibiotics in the erythromycin family might just fit that bill.
“I had a little cold and allergy attack and I didn’t have my inhaler with me.” Paula Puia had an asthma attack a few weeks ago at 35,000 feet. “I couldn’t breathe, it felt like I had an elephant sitting on my chest, and basically I was breathing through a straw. The stewardess gave me oxygen.” Could scary asthma exacerbations like Paula had be mitigated by an antibiotic? That would be a new treatment for Paula and many asthmatics.
But according to new research in the New England Journal of Medicine, antibiotics might help lessen the severity of an asthma flare up. In patients treated either at an urgent care clinic, E.R., or in the hospital, prescribing the antibiotic telithromycin, or Ketek, had significantly greater improvement in asthma symptoms during the ten day treatment period. The benefits continued even six weeks out.
Dr. Len Horovitz, a pulmonologist at Lenox Hill Hospital, says, “Improvement was definitely noted in the group using telithromycin. It definitely worked. This was a convincing study and I would be inclined to try using this antibiotic in a patient who had no sensitivity to it in the instance of a flare up.” Why it works is the big question. “Why? It’s absolutely unclear,” says Dr. Horovitz.
It’s entirely possible the antibiotic is actually fighting an infection and killing bugs. Most patients tested positive to mycoplasma or legionella, two kinds of bacteria. Or, it may be acting, not as a true antibiotic, but rather an anti-inflammatory. In fact, other studies that looked at antibiotics in the erythromycin family have shown them to be effective at preventing the airway from suddenly clamping down.
These antibiotics also decrease proteins in sputum which are part of inflammation. “This was a bit unexpected-- the fact that an antibiotic worked in a situation where there was no bacterial infection. And it makes you wonder whether there are other drugs that are out there already that we can use to improve symptoms of asthma,” says Dr. Horovitz.
But for this one antibiotic, while we don’t know exactly why it works, at least it does work. And it provides perhaps additional armament against this common and debilitating condition. Still, the experts want to see larger studies on greater numbers of patients before labeling these antibiotics as true anti-inflammatory in the treatment of asthma.