From the Guidelines
Antibiotics are not recommended for the treatment of acute asthma exacerbations except as needed for comorbid conditions. Asthma is primarily an inflammatory condition of the airways, not a bacterial infection, so antibiotics are generally ineffective for managing asthma symptoms 1. The mainstay treatments for asthma include inhaled corticosteroids for long-term control, and short-acting bronchodilators for quick symptom relief.
Key Points to Consider
- The use of antibiotics in asthma treatment is generally reserved for patients with clear evidence of a bacterial respiratory infection complicating asthma, such as bacterial pneumonia or sinusitis 1.
- Unnecessary antibiotic use can lead to antibiotic resistance and side effects like diarrhea or allergic reactions.
- Patients should work with healthcare providers to develop an asthma action plan focusing on appropriate controller and rescue medications rather than antibiotics for routine asthma management.
Treatment Approach
- Inhaled corticosteroids, such as fluticasone or budesonide, are the preferred long-term control medications for asthma.
- Short-acting bronchodilators, like albuterol, are used for quick symptom relief during asthma attacks.
- When a bacterial infection is present, antibiotics like amoxicillin or azithromycin may be prescribed, but the choice of antibiotic should target the suspected pathogen 1.
From the Research
Asthma and Antibiotics
- The relationship between asthma and antibiotics is complex, with some studies suggesting that antibiotics may be beneficial in reducing asthma exacerbations, while others have found no significant improvement 2.
- Azithromycin, a type of antibiotic, has been studied as a potential therapeutic choice for asthma control, with mixed results 2, 3.
- A systematic review of seven studies involving 1520 cases found that azithromycin administration resulted in no significant improvement in lung function, symptom assessment, or airway inflammation, and no significant difference in adverse events 2.
- However, a randomised trial found that low-dose azithromycin significantly reduced asthma exacerbations and improved quality of life in patients with severe asthma, regardless of the definition used 3.
- The use of antibiotics in asthma management is not universally recommended, and treatment should be individualized based on the specific needs and circumstances of each patient.
- Other treatments, such as inhaled corticosteroids, long-acting beta2 agonists, and biologics, are also available for the management of asthma, and may be more effective in certain cases 4, 5, 6.