Study finds little benefit to using antibiotics to treat an asthma attack

A summary of research published in the European Respiratory Journal

An asthma exacerbation or attack is a sudden worsening of symptoms for someone with asthma. They can be very serious and, in some cases, require hospital treatment. These attacks are usually treated with two specific types of medication – bronchodilators (usually a blue inhaler) and oral corticosteroids.  

This study aimed to look at whether antibiotics could also be a useful tool to manage an asthma exacerbation.

What did the study look at?

The study looked at the medical records of more than 28,000 people living with asthma. They looked at how people had been treated during an asthma attack. They also looked at whether they had any follow up appointments with their healthcare professional and whether any further prescriptions were given to manage their symptoms.

What do the results show?

The results found that antibiotics were often prescribed for an asthma attack, despite this not being recommended in healthcare guidelines. The findings on the benefits of antibiotic use were mixed:

• There was a small reduction in the number of people (3 in 100) needing a follow-up appointment two weeks after their asthma attack if they were treated with antibiotics and oral corticosteroids.
• In adults, those who were given antibiotics and oral corticosteroids had a small increased chance of needing treatment for an on-going or new exacerbation within 6 weeks of the first attack.

Why is this important?

Guidelines do not recommend using antibiotics to treat an asthma attack, but evidence suggests that many healthcare professionals do prescribe them. There is some evidence from clinical trials that they could help improve symptoms that are getting worse. The findings of this study are taken from real-world data, rather than a clinical trial setting. The results suggest there is very little benefit to including antibiotics as a regular treatment for asthma symptoms that are getting worse. This is important because we should not over-use antibiotics. Overusing antibiotics can lead to antibiotic resistance. Antibiotic resistance means that the bacteria and fungi (germs) that are being treated with antibiotics learn to fight back. Bacteria and fungi that can fight back are harder to treat with antibiotics. This could mean that diseases that are easy to treat now may become very dangerous in the future.

Read the original research paper

Title: A real-life comparative effectiveness study into the addition of antibiotics to the management of asthma exacerbations in primary care

https://erj.ersjournals.com/content/early/2020/12/10/13993003.03599-2020