Asthma Symptoms Misinterpreted as Respiratory Tract Infections?

Asthma symptoms may be mistaken for respiratory tract infections (RTI) in children, and that could mean unnecessary antibiotic prescriptions. Pharmacists are in a good position to help their patients sort out asthma flare-ups from RTIs.

Esmé Baan, MD, from the department of medical informatics, Erasmus University, Rotterdam, The Netherlands and colleagues presented findings this week at the European Respiratory Society International Congress that noted children with asthma were approximately 1.6 times more likely to be prescribed antibiotics, compared to children who do not have asthma.

The study included 1.5 million children from the United Kingdom (UK), including around 150,000 with asthma, and a further 375,000 from The Netherlands, including around 30,000 with asthma. The researchers noted that antibiotic prescription rates were almost 2-fold higher in the UK overall. In both countries, amoxicillin was the most commonly-used antibiotic.

In The Netherlands, there were 197 antibiotic prescriptions per 1,000 children with asthma per year, compared to 126 prescriptions per 1,000 children without asthma. In the UK there were 374 prescriptions per 1,000 children with asthma per year, compared to 250 per 1,000 children without asthma.

The researchers explained that since the pattern of overprescribing antibiotics to children with asthma was the same in both countries, the situation is likely to be the same elsewhere. The Netherlands has some of the lowest antibiotic use in the world, so the situation in other countries where antibiotic use is much higher, such as in Italy, Spain, Portugal and Greece, could potentially be far worse.

In a press release about the study, Baan said: "Asthma is a common and ongoing condition, and it has symptoms that could be mistaken for a respiratory tract infection. However, international and national guidelines clearly state that antibiotics should not be given for a deterioration in asthma symptoms, because this is rarely associated with a bacterial infection. 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."

Reference

1. Children with asthma are being prescribed unnecessary antibiotics [news release]. Milan, Italy. ERS International Congress website. September 11, 2017. https://erscongress.org/about-ers-2017/media-centre-2017/press-releases/121-press-releases/532-bann-asthma-antibiotics.html Accessed September 12, 2017.