Asthma is a chronic condition that affects 1 in 13 Americans. This causes your airways to narrow, which can interfere with breathing.
Currently, research does not support the use of antibiotics to treat asthma except in certain situations, such as when laboratory test results confirm a bacterial infection.
It is not clear what causes asthma. Some factors that may contribute to its development include:
- genetics
- allergies
- environmental factors, like pollution
- respiratory infections
Researchers are examining whether antibiotics can help treat asthma symptoms. Keep reading to learn how antibiotics work and what researchers have found so far.
How Do Antibiotics Work?
Antibiotics are drugs that kill bacteria and prevent their growth. The discovery of antibiotics revolutionized modern medicine. In the less than 100 years since antibiotics were discovered, human life expectancy has increased by 23 years.
Antibiotics are not effective in treating viral, fungal or parasitic infections. Research shows that bacterial infections play a minor role in asthma flare-ups, while viral infections play a major role.
Doctors try to avoid prescribing unnecessary antibiotics because they can cause side effects and contribute to antibiotic resistance. Antibiotic resistance occurs when drugs designed to kill parts of bacteria stop being effective.
According to the Centers for Disease Control and Prevention (CDC), antibiotic resistance is one of the most urgent threats to public health. It causes at least 23,000 deaths in the United States each year.
Can Antibiotics Treat Asthma or Manage Its Symptoms?
A short-term worsening of asthma symptoms is called an asthma attack, flare-up, or exacerbation. In theory, antibiotics can help kill the bacteria that contribute to asthma flare-ups. But bacterial infections seem to account for a small percentage of flare-ups.
The risks of doctors overprescribing antibiotics for asthma may outweigh the benefits in many cases. And researchers haven’t found enough evidence to justify prescribing antibiotics outside of specific circumstances, such as confirmed bacterial infections.
In a 2017 study that reviewed the medical files of 100 hospitalized women, researchers found that respiratory infections caused nearly three-quarters of asthma flare-ups.
About half of these women were prescribed antibiotics, but only 7 percent of them tested positive for a bacterial infection. Women prescribed antibiotics had an average hospital stay of 2.35 days longer, but both groups of women had better outcomes.
Similarly, in a large 2020 study with 110,418 participants, researchers found that people with severe lower respiratory tract infections were more likely to be treated with antibiotics.
In a 2018 review of six studies, researchers investigated whether antibiotics are safe and helpful for people with asthma flare-ups. They concluded that the results of their study supported the British Thoracic Society guidelines that doctors should not routinely prescribe antibiotics for asthma.
Researchers have found a limited amount of evidence that antibiotics given at the time of a flare-up can lead to more symptom-free days, but results were inconsistent across studies. Researchers had less confidence in the results.
When Are Antibiotics Recommended?
Antibiotics can help asthma symptoms in people with confirmed bacterial respiratory infections. Types of bacteria linked to asthma flare-ups include:
- Mycoplasma pneumoniae
- Haemophilus influenzae
- Moraxella catarrhalis
- Chlamydia pneumoniae
- Streptococcus pneumoniae
In a 2021 study, researchers found evidence that antibiotics can improve symptoms in people who are difficult to treat. Of the 101 people with asthma in the study, 61.4% also had chronic obstructive pulmonary disease (COPD), and 77% said their symptoms started after a respiratory illness.
Do Antibiotics Taken for Another Condition Make Asthma Worse?
Exposure to antibiotics in early life, especially antibiotics to treat respiratory infections, may increase the risk of asthma later in life. Research shows that the association is strongest among young children and women.
In a 2022 rat study, researchers found evidence that early use of antibiotics can cause asthma and allergies and kill healthy bacteria in the digestive system.
What Are Effective Treatments for Asthma and Its Symptoms?
There are four main types of medications used to treat asthma. These include:
- Quick-relief medications: Quick-relief medicines are usually given by inhaler and are used only to treat asthma attacks. These include short-acting, rapid-onset beta2-agonists and anticholinergic bronchodilators.
- Controller medications: These medications are used to correct long-term inflammation and excess mucus in your airways. These include anti-inflammatories, anticholinergics and long-acting bronchodilators.
- Combination of quick-relief and controller medications: These medications provide short- and long-term relief of asthma symptoms. However, they are not yet approved by the Food and Drug Administration (FDA) for this purpose.
- Biologics: Doctors may prescribe biologics when other treatments aren’t working or to control a particular trigger. These drugs reduce inflammation by targeting proteins made in your immune system called antibodies.
Summary
Most medical guidelines do not recommend antibiotics for the treatment of asthma unless the asthma does not respond to other treatments or laboratory test results confirm a bacterial infection.
Respiratory infections are a common trigger of asthma flare-ups, but viruses seem to cause most infections. Unnecessary use of antibiotics can contribute to antibiotic resistance and cause side effects.
