Are Antibiotics Helpful in Asthma Exacerbations?

[Argirios Argiriou]

February 5, 2019

Are Antibiotics Helpful in Asthma Exacerbations?

David J. Amrol, MD reviewing Stefan MS et al. JAMA Intern Med 2019 Jan 28

Antibiotics are not needed and might worsen outcomes.

Current guidelines recommend against use of antibiotics for patients with asthma exacerbations, yet almost half of hospitalized patients still receive them. In a retrospective cohort study, researchers examined outcomes among adults hospitalized with asthma who did or did not receive antibiotics.

Among almost 20,000 patients hospitalized with asthma who required systemic corticosteroids, 8788 were treated with antibiotics within their first 2 days of admission; 6833 of these patients were propensity-matched with similar patients who did not receive antibiotics. Median hospital stay length was 29% longer and median hospital costs were significantly higher in the antibiotic group than in the no-antibiotic group. Diarrhea was somewhat more common in the antibiotic group. Treatment failures occurred at similar rates in both groups.

COMMENT
This was a retrospective study and patients treated with antibiotics tended to be older and sicker (although the authors carefully tried to reduce selection bias and confounders), but it supports the current standard of care. Antibiotics are not needed in patients with routine asthma exacerbations.

EDITOR DISCLOSURES AT TIME OF PUBLICATION

Disclosures for David J. Amrol, MD at time of publication

Consultant / Advisory Board

CSL Behring; Horizon Pharmaceuticals

CITATION(S):

Stefan MS et al. Association of antibiotic treatment with outcomes in patients hospitalized for an asthma exacerbation treated with systemic corticosteroids. JAMA Intern Med 2019 Jan 28; [e-pub]. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος