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By Faye Kehler Family Physician and GP Anesthetist since 1987 interested in all aspects of Medicine
Hengameh H Raissy, Kathryn Blake
The National Asthma Education and Prevention Program's Expert Panel Report 3, Guidelines for the Diagnosis and Management of Asthma does not recommend antibiotics for the management of acute episodes of asthma exacerbation. Macrolides seem to have some potential effect beyond or in addition to their antibacterial effect. It has been reported that macrolides may potentially benefit patients with chronic inflammatory airway diseases due to their antibacterial, antiviral, and/or anti-inflammatory effects. This review presents recent data on use of azithromycin in prevention and management of acute exacerbation of respiratory symptoms in infants and young children...
June 1, 2016: Pediatric Allergy, Immunology, and Pulmonology
Matthew Neame, Octavio Aragon, Ricardo M Fernandes, Ian Sinha
Acute, severe exacerbations of asthma present a challenge due to the significant morbidity associated with this presentation. For exacerbations that are refractory to initial treatments with inhaled and oral therapies, there is still doubt about which intravenous therapies are most likely to be helpful. β-2 agonists and aminophylline have differing mechanisms of action that also affect their adverse effects profiles and these are considered. A review of the available randomised control trials suggests that a bolus of intravenous salbutamol may reduce symptoms and hasten recovery...
August 2015: Archives of Disease in Childhood. Education and Practice Edition
Brian H Rowe, Cristina Villa-Roel, Sumit R Majumdar, Riyad B Abu-Laban, Shawn D Aaron, Ian G Stiell, Jeffrey Johnson, Ambikaipakan Senthilselvan
BACKGROUND: Acute asthma is a common ED presentation. In a prospective, multicenter cohort study, we determined the frequency and factors associated with asthma relapse following discharge from the ED. METHODS: Adults aged 18 to 55 years who were treated for acute asthma and discharged from 20 Canadian EDs underwent a structured ED interview and a follow-up telephone interview 4 weeks later. Standardized antiinflammatory treatment was offered at discharge. Multivariable analyses were performed...
January 2015: Chest
Gustavo J Rodrigo, José A Castro-Rodríguez
BACKGROUND: The role of tiotropium for the treatment of asthma has not yet been clearly defined. The aim of this systematic review was to assess the efficacy and safety of tiotropium in patients with asthma. METHODS: Randomized placebo-controlled trials were included. Primary outcomes were peak and trough FEV1 and morning and evening peak expiratory flow (PEF). RESULTS: Thirteen studies (4,966 patients) were included. Three different therapeutic protocols were identified...
February 2015: Chest
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