Trimethoprim-Sulfamethoxazole Improves Lung Function in Pediatric Asthma

Treatment with trimethoprim-sulfamethoxazole was associated with improvements in lung function and decreased visits to the emergency department (ED) among children with asthma, according to study results presented at the American Academy of Allergy, Asthma & Immunology (AAAAI) Virtual Annual Meeting held from February 26 to March 1, 2021.

Trimethoprim-sulfamethoxazole is a hallmark therapy for Pneumocystis, an opportunistic fungus which is associated with inflammation and airway hyperresponsiveness similar to that observed in preclinical asthma models.

This study was a retrospective analysis of electronic medical record (EMR) data obtained from the Children’s Hospital of Pittsburgh. Researchers reviewed EMR data from the hospital of pediatric patients with asthma who received trimethoprim-sulfamethoxazole or clindamycin between 2010 and 2018 in conjunction with 1 pulmonary function test. The primary outcome was improvement pulmonary function, while the secondary outcome was ED visits for asthma exacerbations.

There were noticeable improvements in forced expiratory volume in 1 second (FEV₁) and forced vital capacity (FVC) after treatment with trimethoprim-sulfamethoxazole compared with pulmonary function tests at baseline. Patients treated with trimethoprim-sulfamethoxazole also experienced improved lung function compared with patients who received only clindamycin. These improvements in lung function were observed independently of inhaled corticosteroid dose. Treatment with trimethoprim-sulfamethoxazole was also associated with a decrease in the number of ED visits for asthma approximately 12 months after treatment compared with clindamycin.

Limitations of this study included its retrospective design as well as the restricted pediatric population, which may reduce generalizability of the findings across adult patients with asthma.

The researchers concluded that additional “[p]rospective clinical evaluation of Pneumocystis-centered therapy in patients with asthma is warranted.”

Reference

Eddens T, Wolfe R, Nowalk A, Forno E, Campfield B. Trimethoprim-sulfamethoxazole use is associated with improved lung function in pediatric asthma. Presented at: the American Academy of Allergy, Asthma & Immunology Virtual Annual Meeting 2021; February 26- March 1, 2021. Abstract L13.