ArticleJournal of asthma and allergy2021
Outcomes of Antibiotics in Adults with "Difficult to Treat" Asthma or the Overlap Syndrome.
Article in Journal of asthma and allergy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed, 5 citations in OpenAlex.
- Prevalence and burden of asthma in five European countries: a retrospective cross-sectional study.BMJ open · 2025Article
- Infectious Asthma: An Easily Identified Clinical Presentation with Implications for Diagnosis, Prognosis, Treatment, and Prevention of Asthma.Journal of asthma and allergy · 2022Article
- Potent Anti-Inflammatory Effects of Tetracyclines on Human Eosinophils.Frontiers in allergy · 2021Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMacrolides are a recommended treatment option for severe asthma, but data for "difficult-to-treat" asthma, the asthma-COPD "overlap" syndrome, and treatment duration beyond one year are lacking. We present long-term data from community practice experience providing insights for practice and research.
methodsWe report data from (1) baseline (pre-treatment) chart review of antibiotic-treated asthma patients and (2) follow-up telephone interviews documenting severe exacerbations (NIH criteria), Asthma Control Test (ACT) scores, and asthma controller use at baseline and follow-up, analyzed using a "before-after" model.
resultsA total of 101 patients (mean age 55.6 years (Sd 16.8), 66 females) were included. None had ever taken high dose inhaled corticosteroids and 79 (78.2%) were severely uncontrolled (ACT score ≤15) before treatment. Coexisting COPD was present in 62 (61.4%) patients. Azithromycin or azithromycin plus doxycycline was primarily prescribed with a median treatment duration of 12 months and median follow-up duration of 22 months. Severe exacerbations in the month before treatment occurred in 50.5% vs 17.8% at follow-up (P<0.0001). Mean ACT score increased from 12.2 to 20.6 (P<0.0001). The number of patients taking controller medications decreased (P<0.0001 for inhaled corticosteroids; P<0.001 for long-acting beta agonist/long-acting muscarinic antagonist; P<0.05 for leukotriene receptor antagonists). Of the 79 severely uncontrolled patients, 51 (64.6%) became controlled at follow-up, and of these 51, 27 (52.9%) continued to take antibiotics while 24 (47.1%) had discontinued antibiotics earlier yet remained controlled.
conclusionAntibiotic treatment may be beneficial in a significant proportion of "difficult to treat" asthma patients beyond one year, including some patients with the overlap syndrome and/or who fail to meet criteria for refractoriness.
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