Increased risk of treatment failure for children with asthma exacerbations presenting to the ER
THURSDAY, June 7, 2018 (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, M.D., 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.
The researchers found that 61.7 percent of the 958 participants were positive for one or more pathogens (29.4 percent rhinovirus), and that 16.9 percent 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 versus 12.5 percent; risk difference, 8.2 percent). There was a correlation for non-rhinovirus pathogens with increased absolute risk of treatment failure by 13.1 percent; specifically, by 8.8, 24.9, and 34.1 percent 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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