Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Antibiotic Therapy in Patients with Asthma

JAMA Intern Med; ePub 2019 Jan 28; Stefan, et al

In adult patients hospitalized for asthma and treated with corticosteroids, antibiotic treatment may not be associated with better outcomes and should not be prescribed routinely, a new study suggests. The retrospective cohort study of 19,811 patients had a primary outcome measure of hospital length of stay. Other measures included treatment failure within 30 days of discharge, hospital costs, and antibiotic-related diarrhea. Researchers found:

  • 8,788 (44%) patients received antibiotics during the first 2 days of hospitalization.
  • Treated patients were older, more likely to be white and smokers, and had a higher number of comorbidities.
  • Compared with patients who were not treated with antibiotics, treated patients had a significantly longer hospital stay, similar rate of treatment failure, and higher risk of antibiotic-related diarrhea.
  • Patients treated with antibiotics also had a higher cost of hospitalization.


Stefan MS, Shieh M, Spitzer KA, et al. Association of antibiotic treatment with outcomes in patients hospitalized for an asthma exacerbation treated with systemic corticosteroids. [Published online ahead of print January 28, 2019]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.5394.