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.

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.

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“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.

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Two authors disclosed financial ties to the pharmaceutical industry.

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