The Unnecessary Burden of Prescribing Antibiotics to Asthma Patients without Proof of Infection

By the bioMérieux Connection Editors

In addition to promoting antibiotic resistance, a recent study illustrates how giving antibiotics to patients with asthma exacerbation without any documented indication of lung infection can lengthen hospital stay, increase cost of care and result in increased risk for antibiotic-related diarrhea.

According to the researchers, this study is the largest observational comparative effectiveness study to date of patients hospitalized with asthma exacerbation. The researchers reviewed medical records of those hospitalized for asthma from 554 hospitals in the U.S. over a 2-year period.

Patients with secondary conditions that might justify antibiotic use (sinus infection, pneumonia, bronchitis, emphysema, sepsis, and any other condition that should be treated with antibiotics) were excluded. The study population included 22,043 patients, which represents 46 percent of all hospitalized asthma patients over the study time period,  who were treated with antibiotics with 48 hours of admission.

Specifically, the group of hospitalized asthma patients who received antibiotics versus those who did not had:

  • Extended hospital stays (4.64 vs 3.4 days)
  • Higher hospitalization costs ($6,427 vs. $5,387)
  • Suffered a far greater risk of antibiotic-related diarrhea (55 percent higher risk vs those not treated with antibiotics)

Furthermore, there was no difference in treatment failure when the researchers looked at those treated with antibiotics and those who were not. For this study, treatment failure included:

  • Initiation of mechanical ventilation
  • Transfer to the intensive care unit as of the second day of admission
  • Readmission for asthma exacerbation within 30 days of discharge
  • In-hospital mortality

The researchers concluded that, “These findings suggest a significant opportunity to improve patient safety, reduce the spread of resistance, and lower spending through greater adherence to guideline recommendations. We hope these results prompt hospital-based clinicians to examine local treatment patterns, and attract the attention of professional societies and government agencies charged with promoting antimicrobial stewardship.”


Opinions expressed in this article are not necessarily those of bioMérieux, Inc.

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