Welsh researchers uncover link between patients with resolved asthma and respiratory tract infections

Researchers at Wales Centre for Primary and Emergency Care Research (PRIME Centre Wales), funded by Health and Care Research Wales, have discovered that primary care patients with a history of resolved asthma face a higher risk of respiratory tract infections and antibiotic use, compared with the general population.

The study is led by Dr Harry Ahmed, a Health and Care Research Wales Faculty member and Dr Rebecca Cannings-John, both co-lead of PRIME's research in infections and antimicrobial resistance.

Dr Ahmed said currently there is no guidance for regular assessment or review of people deemed to have resolved asthma, and little is known about their ongoing risk of adverse respiratory events.

He added: “The project originated from a query by a patient who had suffered from asthma since childhood. Over time, their condition improved to the point where they no longer needed medication and could engage in exercise and other activities without any problem.

“However, they noticed they were experiencing frequent respiratory infections. After some years, they requested lung function tests and were informed that they had asthma again, prompting them to restart treatment.

“Once treatment had been in place for a few months, they noticed that the respiratory infections ceased.”

Asthma is a chronic respiratory condition affecting around 339 million people worldwide. In a proportion of people, asthma symptoms will resolve and these patients will no longer have the same follow-up they had whilst they needed asthma medications.

The team used data from patients registered with GPs across England to look at whether individuals whose asthma has resolved continue to face a risk of respiratory infections.

The team found that patients with resolved asthma had significantly more general practice visits for respiratory infections and received more antibiotic prescriptions compared to those without a history of asthma.

However, the rates of serious respiratory infections requiring hospital admission were similar between those with resolved asthma.

Dr Ahmed said “Our overall conclusion was that we may need to undertake a more comprehensive respiratory assessment if a patient with resolved asthma presents with respiratory infection symptoms, in order to evaluate symptom burden, airway obstruction and the potential benefit of restarting inhalers.”

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