Antibiotics for asthma attacks: Masking uncertainty

Document Type

Journal Article

Publication Title

European Respiratory Journal

Volume

58

Issue

1

Publisher

European Respiratory Society

School

School of Medical and Health Sciences

Comments

Ramakrishnan, S., & Couillard, S. (2021). Antibiotics for asthma attacks: Masking uncertainty. European Respiratory Journal, 58, article 2100183. https://doi.org/10.1183/13993003.00183-2021

Abstract

The role for antibiotics in acute asthma has been historically overestimated [1]. From a mechanistic point of view, multiplex PCR testing and conventional microbiological techniques show that > 50–80% of events are associated with viral infections, and less than 20% associated with evidence of bacterial infection, with the remaining proportion presumed to be due to allergies and irritants [2]. Consequently, antibiotics are not expected to work in the context of most asthma attacks and their routine use is not recommended. This stance is supported by a Cochrane review, which found inconsistent data to support antimicrobial use [3] and a good quality retrospective cohort study, which associated the combination of antibiotics and oral corticosteroids (OCS) with a longer hospital length of stay, higher hospital cost, and similar risk of treatment failure compared to matched patients treated only with OCS alone [4].

DOI

10.1183/13993003.00183-2021

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