The Pharmaceutical Journal
Vol 276 No 7397 p470
22 April 2006

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Antibiotics in asthma attacks

Antibiotic treatment with telithromycin (Ketek) may provide some benefit to patients who have had an asthma attack, according to a recent study (New England Journal of Medicine 2006;354:1589).

A total of 278 patients were randomised to receive, in addition to standard care, either oral telithromycin (800mg daily for 10 days) or placebo beginning within 24 hours of an acute exacerbation. The investigators found, throughout the 10-day period, a greater improvement in asthma symptoms in the treatment arm than in the placebo arm (mean difference in symptom score reduction –0.3 point, 95 per cent confidence interval, –0.5 to –0.1; P=0.004). However, morning peak expiratory flow rates (the other primary outcome measure) were not found to be different between the two groups.

The exact mechanism of action of telithromycin’s benefit in this setting is unknown. The authors admit that the data, although providing some new evidence, cannot provide clinical guidance for use of the drug in acute asthma exacerbation, and that further study is required to confirm the results.