1. Outcomes of Antibiotics in Adults with 'Difficult to Treat' Asthma or the Overlap Syndrome
- Author
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Fred A Wagshul, Nikki M Schultek, David L Hahn, and Doris T Brown
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.drug_class ,Antibiotics ,overlap syndrome ,Azithromycin ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Immunology and Allergy ,Medicine ,0601 history and archaeology ,Asthma ,Doxycycline ,COPD ,060102 archaeology ,macrolides ,business.industry ,case series ,Muscarinic antagonist ,Overlap syndrome ,06 humanities and the arts ,asthma ,tetracyclines ,medicine.disease ,030228 respiratory system ,Difficult to treat asthma ,“difficult to treat” asthma ,business ,medicine.drug - Abstract
Purpose Macrolides 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. Methods We 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. Results A 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, Video abstract Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/0vF55ewkTVc
- Published
- 2021