- This study found high-use of antibiotics and asthma medications for the treatment of acute lower respiratory tract infections (ALRTIs) in patients with and without asthma, respectively, with considerable between-practice variation.
Why this matters
- Despite limited evidence of benefits and in contradiction to national guidelines, general practices are continuing to frequently prescribe antibiotics for ALRTIs.
- This retrospective cohort study included 110,418 patients with (n=17,952) or without (n=92,466) using data from the Clinical Practice Research Datalink (CPRD).
- Funding: NIHR Research Professorship.
- Overall, 127,976 incidences of ALRTIs were reported; 81.1% and 79.4% of patients with and without asthma received antibiotics and 41.1% and 14.7% asthma medication.
- There were significant differences in between-practice prescribed for all treatments, with greatest differences observed for:
- oral steroids:
- with (OR, 17.76; 95% CI, 6.55-81.91) and without (OR, 93.92; 95% CI, 33.15-362.72) asthma.
- asthma medication only:
- with (OR, 7.46; 95% CI, 4.00-18.46) and without (OR, 17.18; 95% CI, 10.08-33.1) asthma.
- oral steroids:
- In patients with asthma, independent predictors of antibiotic prescription included:
- fewer previous ALRTI episodes (OR, 0.25; 95% CI, 0.17-0.39);
- higher practice (OR, 1.47; 95% CI, 1.35-1.59);
- prior antibiotic prescription (OR, 1.28; 95% CI, 1.04-1.57); and
- concurrent asthma medication (OR, 1.44; 95% CI, 1.32-1.57; P<.001 for all>
- Higher previous asthma medication prescription (OR, 2.31; 95% CI, 1.83-2.91) and concurrent antibiotic prescription (OR, 3.59; 95% CI, 3.22-4.01; P<.001 for both were independent predictor of asthma medication in patients without asthma.>
- Retrospective design.