Unnecessary antibiotics prescribed for asthma patients, unless there is a strong presence of lung infection, are not required suggests Clinical guidelines, and the Global Initiative for Asthma , reveals a recent study by author Mihaela S. Stefan, MD, PhD, a research scientist at the Institute for Healthcare Delivery and Population Science and associate professor at the University of Massachusetts Medical School in Springfield.// Dr. Stefan noted that a prior study conducted by her research group found that 60 percent of patients received antibiotics without an indication of lung infection. "Nevertheless, few studies have assessed whether antibiotics could be beneficial in these patients," she added.
Of the remaining 22,043 patients, 46.1 percent were treated with antibiotics within their first two hospital days. The researchers conducted several types of analyses. Using propensity-matched analysis, which they characterized as the most "robust," they found that those receiving antibiotics had:
- longer hospital stays, 4.64 vs 3.4 days
- higher hospitalization costs, $6,427 vs. $5,387
- a 55 percent higher risk of antibiotic-related diarrhea.
There was no difference in treatment failure between those who received antibiotics and those who did not. Treatment failure was defined as the initiation of invasive or noninvasive mechanical ventilation, transfer to the intensive care unit after hospital day two, and in-hospital mortality or readmission for asthma exacerbation within 30 days of discharge.
"Our results strengthen the evidence that antibiotics should not be prescribed routinely in adult patients hospitalized with asthma," Dr. Stefan said, adding that all patients in the study had received systemic steroids and bronchodilators, the standard of care for patients experiencing an asthma exacerbation. "All hospitals should assess their practice in caring for patients hospitalized with asthma and increase their antibiotic stewardship."