Aim:

The aim of this study was to evaluate the prevalence of atypical pathogens such as Mycoplasma pneumoniae (MP), Chlamydia pneumoniae (CP) and Chlamydia trachomatis (CT) in children with bronchial asthma and assess the efficacy of azithromycin (Sumamed, Pliva, Croatia) in acute asthma exacerbation as a part of complex therapy.

Methods:

Children with acute asthma exacerbation were enrolled in the study. In all children PCR (sera and sputum), serological tests (IgM and IgG) for MP, CP and CT, detection of MP antigen (AG) in nasal aspirate by using immunofluorescence method (IFA) were performed.

Results:

A total of 76 children, aged 6 months–14 years, with acute asthma exacerbation were enrolled in the study. 29 of them have mild asthma, 28 – intermediate and 19 – severe asthma. Previous history of the disease was 1 month–10 years. Acute respiratory infections were the trigger of asthma exacerbation in majority (88.2%) of children. The prevalence of MP, CP and CT infections among children found to be very high (54–89%). As a result of high prevalence of MP, CP and CT infections in children, with asthma exacerbation, 5-day azithromycin was added to the complex antiasthmatic treatment. Clinical success of the treatment was achieved in majority of children (91.3%), regardless the severity of asthma exacerbation. We found rapid regression of fever and symptoms of intoxication after 2–3 days of onset of treatment. During the follow-up period (6 months) we found that 79.1% of children did not suffer from acute infections and asthma exacerbations.

Conclusions:

The prevalence of MP, CP and CT infections among children included in the study found to be very high. The results suggest that such patients may have benefit with short courses of azithromycin. Nevertheless, further studies are needed in order to assess the role of azithromycin in chronic persistence of atypical pathogens in respiratory tract in children with asthma.