This site is intended for UK healthcare professionals
Medscape UK Univadis Logo
Medscape UK Univadis Logo
Clinical Summary

Antibiotics and asthma medication for acute LRTI in people with and without asthma

Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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.
  • 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.

Limitations

  • Retrospective design.

References


YOU MAY ALSO LIKE