Respiratory Pathogens May Up Treatment Failure Risk in Asthma

Increased risk of treatment failure for children with asthma exacerbations presenting to the ER.
Increased risk of treatment failure for children with asthma exacerbations presenting to the ER.

HealthDay News — Respiratory pathogens are associated with increased risk of treatment failure in children with asthma exacerbations, according to a study published online June 4 in Pediatrics.

Joanna Merckx, MD, from Montreal Children's Hospital, and colleagues performed a secondary analysis of the Determinants of Oral Corticosteroid Responsiveness in Wheezing Asthmatic Youth study, involving children aged 1 to 17 years presenting to the emergency department with moderate or severe exacerbations. The correlation between pathogens and exacerbation severity and treatment failure of a standardized severity-specific treatment was assessed. 

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The researchers found that 61.7% of the 958 participants were positive for one or more pathogens (29.4% rhinovirus), and that 16.9% of participants experienced treatment failure. There was no correlation for the presence of any pathogen with higher baseline severity, although there was a correlation with higher risk of treatment failure (20.7 vs 12.5%; risk difference, 8.2%). There was a correlation for non-rhinovirus pathogens with increased absolute risk of treatment failure by 13.1%; specifically, by 8.8, 24.9, and 34.1% for respiratory syncytial virus, influenza, and parainfluenza, respectively.

"This supports influenza prevention in asthmatic children, consideration of pathogen identification on presentation, and exploration of treatment intensification for infected patients at higher risk of treatment failure," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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