Respiratory tract infections that lead to wheezing
in children are often a result of viral infection and do not warrant the use of
antibiotics. Adding an antibiotic to the treatment regimen not only increases the
cost of treatment but it also runs the danger of making bacteria resistant to
the antibiotic. This could result
in future ineffectiveness of the antibiotic.
Antibiotics should be used judiciously only after a
culture and sensitivity test. In serious
cases where one cannot wait for the results of the test, blood or other samples
should be collected and sent for testing.
Following this, an antibiotic that acts against a large number of
bacteria or a broad spectrum antibiotic should be administered to the
patient. Once the result of the culture
and sensitivity test is obtained, the antibiotic should be changed to one that
the bacteria are specifically sensitive to.
patients usually do not require antibiotics unless they develop respiratory tract
A study was conducted in Belgium to
understand the use of antibiotics with antiasthma drugs in children with
asthma. The study was conducted over 2
years. The authors found that there was
a 3.12% decrease in the use of antibiotics in asthmatic children in the second
year. During the second year, it was
observed that 73.50% children on asthma drug received an antibiotic in the same
year and 38.62% children received an antibiotic without an asthma drug during
the same year. More importantly, about a third of the children were dispensed an
antibiotic with an antiasthma drug on the same day.
Among the antibiotics, penicillins were most
commonly prescribed followed by macrolides and cephalosporins. The cost of treatment was also high with the
use of additional antibiotics.
The authors also deduced from the study that
nebulization is overused in young children, and DPI and automatic inhalers are
underused in older children.
The authors suggest that education of clinicians to
reduce co prescription of antiasthma drugs and antibiotics unless necessary may
help to reduce the use of antibiotics in children.
1. De Boeck K, Vermeulen F, Meyts I, Hutsebaut L, Franckaertc D,
Proesmans M. Coprescription of Antibiotics and Asthma Drugs in Children. Pediatrics doi: 10.1542/peds.2009-3068.