Rotterdam, Netherlands—A recent presentation at the European Respiratory Society International Congress 2017 put the spotlight on a worldwide problem: inappropriate prescribing of antibiotics for pediatric asthma.
The study included 1.5 million children in the United Kingdom and 375,000 in The Netherlands, of which about 10% had asthma. Children with asthma were twice as likely to be prescribed antibiotics than children without asthma in the UK and 1.6 times more likely to receive an antibiotic prescription in The Netherlands, according to University of Rotterdam–led researchers.
Similarity in prescribing practices in the two countries suggests a widespread problem globally, according to study authors, especially since The Netherlands has one of the lowest rates of antibiotic use in the world. Previous studies have found that U.S. physicians write 1 million prescriptions each year for antibiotics to children with a diagnosis of asthma or bronchospasm.
“Antibiotics should only be given when there is clear evidence of a bacterial infection such as for pneumonia. However, we saw that, in children with asthma, most of the antibiotic prescriptions in children were intended for asthma exacerbations or bronchitis, which are often caused by a virus rather than bacteria,” explained coauthor Esmé Baan, MD, of Erasmus University, Rotterdam, The Netherlands.
Guidelines in the United States and Europe recommend against antibiotic usage for asthma exacerbations without an identified bacterial coinfection, such as pneumonia or sinusitis. Otherwise, those guidelines point out, patients might be exposed to unnecessary side effects and that the practice contributes to the development of drug-resistant bacteria without providing any benefit.
“Inappropriate use of antibiotics can be bad for individual patients and the entire population, and makes it harder to control the spread of untreatable infections,” Baan noted. “Antibiotics should only be given when there is clear evidence of a bacterial infection, such as for pneumonia. However, we saw that, in children with asthma, most of the antibiotic prescriptions in children were intended for asthma exacerbations or bronchitis, which are often caused by a virus rather than bacteria.”
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