How Are Asthma Outcomes Affected By Early Antibiotic Treatment?

Early treatment with antibiotics in children with asthma exacerbation is associated with increased length of hospital stay, higher costs, and risk of probiotic use without improvement of treatment effectiveness or readmission rates, according to the results of a recent study.

In order to determine the effectiveness of antibiotic use among this population, the researchers conducted a retrospective cohort study involving data from 48,743 children hospitalized with asthma exacerbation who had no indications of bacterial infection.

Overall, 41% (19,866) of the children received antibiotic treatment, which was associated with longer hospital stay (mean difference 0.21 days; 95% CI, 0.18-0.28), higher costs (mean difference $83.5; 95% CI, 62.9-104.0), and higher risk of probiotic use (risk ratio 2.01; 95% CI, 1.81-2.23) compared with children who did not receive antibiotics. Risk of mechanical ventilation and 30-day readmission, however, were similar among the groups or slightly higher in those treated with antibiotics.

“Professional society guidelines recommend against routine early antibiotic use in the treatment of asthma exacerbation without comorbid bacterial infection,” the researchers wrote.

“Our findings highlight the need for reducing inappropriate antibiotic use among children hospitalized for asthma,” they concluded.

—Michael Potts


Okubo Y, Horimukai K, Michihata N, et al. Association between early antibiotic treatment and clinical outcomes in children hospitalized for asthma exacerbation. JACI. 2020;147(1):114-122.E14.