macrolides for the long term management of asthma found significant effects on asthma symptoms, quality of life, bronchial hyper reactivity and peak flow but not FEV1. More recent positive results of long-term treatment with azithromycin on asthma exacerbations and quality-of-life in patients with severe, refractory asthma have resulted in azithromycin now being recommended in international guidelines as a treatment option for these types of patients. A recent case series of 101 adults with asthma reported that macrolides (mostly azithromycin) and tetracyclines, either separately or in combination, appeared to be dramatically efficacious in a subgroup of "difficult-to-treat" (i.e., not necessarily refractory to high-dose inhaled corticosteroids but who did not take them) patients with severe asthma, many of whom also had the "overlap syndrome" (asthma and COPD). Randomized, controlled trials that include these types of asthma patients are needed. Chlamydia pneumoniae infection is also associated with schizophrenia. Many other pathogens have been associated with schizophrenia. Vaccine research There is currently no vaccine to protect against Chlamydia pneumoniae. Identification of immunogenic antigens is critical for the construction of an efficacious subunit vaccine against C. pneumoniae infections. Additionally, there is a general shortage worldwide of facilities that can identify/diagnose Chlamydia pneumoniae. References External links Chlamydia Pneumoniae cpnhelp.org Type strain of Chlamydopila pneumoniae at BacDive - the Bacterial Diversity Metadatabase Chlamydiota Infectious causes of cancer