INFECŢIILE RESPIRATORII - BENEFICIU SAU FACTOR AGRAVANT PENTRU ASTM?

Asthma is a primary cause of death in 0.4% of total deaths; this could be avoided with correct treatment, according to the standards. In the clinical manifestation of asthma, the respiratory infections play an important role, as a possible trigger for the developpment of the disease or its exacerbation. Occuring in the childhood, the type and number of infections could direct the immune system towards an atopic or non-atopic pattern (while the sincitial respiratory virus is a risk factor for development of recurent wheezing in childhood and later development of asthma, exposure to other viral infections may protect against asthma - hygiene hypothesis of asthma). Most of the exacerbations in children and adults are associated with viral infections; also, due to asthma, these patients have lower resistance to these infections. Among bacterial infections, the infections with Mycoplasma or Chlamydia at early age may predict atopy and asthma. At the asthmatic patient, these infections are predictive for severe exacerbations and the persistence of these bacteria is a predictor for uncontrolled, difficult to treat asthma. On the other hand, Mycoplasma infections at non-atopic patients have a protective role against later development of atopy. Many times in the asthma history, the patient receives antibiotic treatment during exacerbations, against the lack of guideline recommendation. One new indication of antibiotic use in asthma could be for macrolides, as anti-inflammatory use in patients with severe exacerbations or uncontrolled asthma, but further studies are required. [ABSTRACT FROM AUTHOR]