Antibiotics for Asthma: Effectiveness and Proven Treatments

Antibiotics are drugs that kill and inhibit the growth of bacteria. The discovery of antibiotics revolutionized modern medicine. In just over 100 years since the discovery of antibiotics, human lifespan has increased by 23 years.

Antibiotics are not effective in treating viral, fungal, or parasitic infections. To research suggests that bacterial infections play a minor role in asthma flare-ups, while viral infections play a major role.

Doctors try to avoid prescribing unnecessary antibiotics because they can cause side effects and contribute to antibiotic resistance. Antibiotic resistance occurs when drugs designed to kill certain strands of bacteria stop working.

According to Centers for Disease Control and Prevention (CDC), antibiotic resistance is one of the most pressing threats to public health. It causes at least 23,000 deaths a year in the United States.

Short-term worsening of asthma symptoms is called an asthma attack, flare-up, or exacerbation. Theoretically, antibiotics could help kill bacteria that contribute to asthma flare-ups. But bacterial infections seem to make up a small percentage of outbreaks.

The risks of doctors prescribing too many antibiotics for asthma can outweigh the benefits in many cases. And researchers haven’t found enough evidence to support prescribing antibiotics outside of specific situations, such as a confirmed bacterial infection.

In a study 2017 who reviewed the medical records of 100 hospitalized women, the researchers found that respiratory infections were the cause of nearly three-quarters of asthma flare-ups.

About half of these women were prescribed antibiotics, but only 7% of them tested positive for bacterial infections. Women who were prescribed antibiotics stayed in hospital an average of 2.35 days longer, but both groups of women performed well.

Likewise, in a large study 2020 with 110,418 participants, researchers found that people with acute lower respiratory tract infections were overtreated with antibiotics.

In a 2018 review of six studies, researchers investigated whether antibiotics were safe and helpful for people with asthma flare-ups. They concluded that the results of their study confirmed the position of the British Thoracic Society guidelines that doctors should not routinely prescribe antibiotics for asthma.

Researchers found a limited amount of evidence that antibiotics given at the time of a flare may lead to more symptom-free days, but results were inconsistent across studies. The researchers had low confidence in the results.

When are antibiotics recommended?

Antibiotics can relieve asthma symptoms in people with a confirmed bacterial respiratory infection. Types of bacteria linked to asthma flare-ups include:

• Mycoplasma pneumoniae
• Haemophilus influenzae
• Streptococcus pneumoniae
• Chlamydia pneumoniae
• Moraxella catarrhalis

The antibiotic azithromycin is sometimes included as a treatment option for severe asthma that does not respond to other treatments in the guidelines of the:

• Global Asthma Initiative
• European Respiratory Society / American Thoracic Society
• British Chest Society

In a study 2021, researchers have found evidence that antibiotics can improve symptoms in people with hard-to-treat asthma. Of the 101 people with asthma in the study, 61.4% also had chronic obstructive pulmonary disease (COPD) and 77% said their symptoms started after a respiratory illness.

Exposure to antibiotics early in life, especially antibiotics to treat respiratory infections, can lead to an increased risk of asthma later in life. To research suggests that the association is strongest in young children and women.

In a 2022 Rodent Studyresearchers have found evidence that early exposure to antibiotics can cause asthma and allergies by killing healthy bacteria in the digestive tract.

Four the main types of drugs are used to treat asthma. They understand:

• Quick rescue medications: Quick-relief medications are usually delivered through an inhaler and used only to treat asthma attacks. They include rapid-acting and short-acting beta2-agonists and anticholinergic bronchodilators.
• Controller medications: These drugs are used to correct long-term swelling and excess mucus in the airways. They include anti-inflammatories, anticholinergics, and long-acting bronchodilators.
• Combination of fast-acting and controller drugs: These medications provide both short-term and long-term relief from asthma symptoms. However, they have not yet been approved by the Food and Drug Administration (FDA) for this purpose.
• Organic Products : Doctors may prescribe biologics when other treatments don’t work or to control a particular trigger. These drugs reduce inflammation by targeting proteins made in your immune system called antibodies.

Avoiding asthma triggers can also help you manage symptoms. Common triggers to understand:

• stress
• strenuous exercise (but avoiding exercise altogether is not recommended)
• extreme temperatures
• certain medications, such as aspirin
• smoke, pollution, fumes and other airborne irritants
• allergens, such as pollen, dust mites, or animal dander

Most medical guidelines do not recommend antibiotics for the treatment of asthma, except when asthma does not respond to other treatments or laboratory test results confirm a bacterial infection.

Respiratory infections are a common trigger for asthma flare-ups, but viruses seem to cause most infections. Unnecessary use of antibiotics can contribute to antibiotic resistance and cause side effects.