Azithromycin may improve asthma control in kids by reducing exacerbations

New Delhi: The administration of azithromycin to children having poorly controlled asthma resulted in better asthma control and fewer exacerbations, says an article published in CHEST Journal, on 21st February 2022.

Azithromycin has immunomodulatory properties, and it has been shown to be useful in asthmatic adults. There is a scarcity of data about children. As a result, Jagat Jeevan Ghimire and colleagues undertook this trial to determine if adding oral azithromycin (I) to conventional medication (C) in children with poorly controlled asthma (P) improves asthma control (O) when compared to standard treatment alone.

This open-label controlled randomized study recruited children (5-15 years old) with poorly controlled asthma as determined by a score of 19 on the asthma control test (ACT)/childhood asthma control test (CACT). They were randomly assigned to either conventional therapy or azithromycin (10 mg/kg/dose) three times a week for three months. At three months, the primary outcome was the ACT/CACT score. Secondary outcomes were asthma management according to GINA standards, the frequency of exacerbations, changes in spirometry parameters, changes in FeNO, positive throat swab results, and side effects.

The results of this stated as follow:

1. The study included 120 children (89 boys) (60 in each group). The average age was 9.9 years.

2. The groups' baseline parameters were comparable. At three months of intervention, the mean (SD) ACT/CACT score (available for 115 children) was [21.71 (2.17) vs 18.33 (2.19)] in the azithromycin and control groups, respectively.

3. According to GINA recommendations, the number of children with well-controlled asthma was 41/56 versus 10/56 in the azithromycin and control groups, respectively.

4. The azithromycin group had a lower median (IQR) number of exacerbations necessitating an emergency visit and steroid treatment [0 (3) vs. 1 (6); p-value 0.001].

5. There was no difference between the groups in terms of FeNO, spirometry parameters, throat swab positive, or side effects.

In conclusion, when compared to standard therapy alone, the addition of oral azithromycin to standard treatment improved asthma control and reduced exacerbations in children with poorly controlled asthma.

Reference:

Ghimire, J. J., Jat, K. R., Sankar, J., Lodha, R., Iyer, V. K., Gautam, H., Sood, S., & Kabra, S. K. (2022). Azithromycin for Poorly Controlled Asthma in Children: A randomized controlled trial. Chest, S0012-3692(22)00293-8. Advance online publication. https://doi.org/10.1016/j.chest.2022.02.025

Keywords: throat swab, azithromycin, asthma, pediatrics, exacerbations, pulmonary function, antibiotics, asthma control, asthma in children, chest journal, poorly controlled asthma