A real-life comparative effectiveness study into the addition of antibiotics to the management of asthma exacerbations in primary care
A comparative effectiveness study utilising historic electronic medical records from the Optimum Patient Care Research Database (opcrd.co.uk) was conducted to assess the effectiveness of the addition of antibiotics alongside oral corticosteroids for treating asthma exacerbations. The results of this study by the REG Child Health Working Group have been published in the European Respiratory Journal.
The study highlights a high level of antibiotic prescribing in relation to asthma exacerbations, despite this being contrary to guideline recommendations.
Previous randomised controlled trial data has suggested a potentially beneficial effect of antibiotics, in particular macrolides, in asthma exacerbations treated in secondary care. In the large heterogeneous primary care population in this study the use of antibiotics alongside oral corticosteroids for treating asthma exacerbations was associated with a small reduced risk of having a further respiratory consultation in the following two weeks, compared to oral corticosteroids alone. This small effect was seen in those prescribed penicillins, but not in those prescribed macrolides.
Given the small magnitude of the effect and considering the risk of side effects, the cost and most importantly risk of antibiotic resistance associated with the addition of antibiotics it was concluded that the routine addition of antibiotics to oral corticosteroids for the management of asthma exacerbations appears to confer little clinical benefit.
https://erj.ersjournals.com/content/early/2020/12/10/13993003.03599-2020
