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.
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Antibiotic Therapy in Patients with Asthma, JAMA Intern Med; ePub 2019 Jan 28; Stefan, et al
Asthma Toolkit Improves Measures of Asthma Care, J Am Board Fam Med; 2019 Jan; Colborn, et al
Fractional Exhaled Nitric Oxide Testing in Asthma, Mayo Clin Proc; ePub 2017 Dec 20; Wang, et al
Pharmacologic Tx of Seasonal Allergic Rhinitis, Ann Intern Med; ePub 2017 Nov 28; Wallace, et al