Antibiotic telithromycin is effective at treating acute asthma attacks

Researchers have demonstrated that an antibiotic is effective at treating acute asthma attacks, potentially providing a new way to help asthma sufferers.

Research published in the New England Journal of Medicine, shows that the antibiotic, telithromycin, can hasten the recovery time of patients who have had asthma attacks by three days, as well as reducing their symptoms and improving lung function.

Treatment for some serious asthma attacks can involve the use of steroids, which help control inflammation of the lungs and bronchodilators to open airways.

The researchers tested telithromycin, an antibiotic made by sanofi-aventis and not currently used for treating asthma, as part of the TELICAST (TELIthromycin, Chlamydophila and ASThma) study. The study investigated 278 patients at 70 centres around the world, including St Mary’s Hospital, London.

The team included researchers from Imperial College London, the University of Milan, the University of Auckland, the National Jewish Medical Centre, USA, G.R. Micro Ltd, London, and sanofi-aventis, USA.

The patients were enrolled in the study within 24 hours of an acute asthma attack requiring acute medical care. They were then randomised double blind to either ten days oral treatment with a single 800mg dose of telithromycin daily, or placebo in addition to usual treatment. Telithromycin is currently not licensed to treat asthma.

Symptoms and lung function for the patients in the telithromycin group improved significantly compared to those in the placebo group, with improvements being around twice as great at the end of the treatment period. Recovery time was also cut from an average of eight days for the placebo group, to five days for those in the telithromycin group.

Although most acute asthma attacks are recognised to be associated with viral infections, the researchers believe the positive effects of telithromycin may be a result of its impact on the atypical bacteria, Chlamydophila pneumoniae and Mycoplasma pneumoniae. They found 61 percent of the patients in the study were serologically positive for C. pneumoniae and/or M. pneumoniae, and believe the presence of these bacteria may increase the severity of asthma attacks. The researchers also believe the anti-inflammatory properties of telithromycin may play a part in reducing recovery time.

Professor Sebastian Johnston from Imperial College London, who led the research, said: “Traditionally antibiotics have not proven effective in treating asthma attacks, but this development could open up a whole new area of research in the treatment of asthma. Although we’re not sure about the exact mechanism which caused this antibiotic to be effective, this study indicates it does clearly have a beneficial effect. We still need further trials to confirm these results, to investigate the mechanisms of action of this treatment, to see if the same benefits are seen with other related antibiotics and to see which patients are most likely to benefit.”