Takeaway
- Routine, nonempirical antibiotic use offers no benefit and lengthens hospital stay among children hospitalized for asthma exacerbation.
- These results are from a large retrospective cohort study of almost 50,000 children.
Why this matters
- Antibiotics should not be routinely prescribed in children hospitalized for asthma exacerbation.
- This study provides further support for professional society guidelines that recommend against routine use of antibiotics.
Study design
- Retrospective analysis of data from an inpatient database (N=48,743), University of Tokyo (2010-2018).
- 41% of the cohort received antibiotics in the absence of infection, and the remainder received no antibiotics.
- The primary outcome was length of hospital admission.
- Funding: Ministry of Health, Labour, and Welfare, Japan.
Key results
- Based on propensity score matching analysis, with early antibiotics vs no antibiotics:
- Longer hospitalization: mean difference, 0.21 (95% CI, 0.17-0.25) days.
- Higher hospitalization costs: mean difference, $83.50 (95% CI, $62.90-$104.00) USD.
- Higher risk for probiotic use to combat antibiotic-associated diarrhea: risk ratio, 2.01 (95% CI, 1.81-2.23).
- Groups did not differ in treatment failure (need for mechanical ventilation) or 30-day readmission.
Limitations
- Single-center.
- Retrospective, observational.
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