Antibiotics for acute asthma.
BACKGROUND
Antibiotics are often prescribed to patients who are admitted to hospital with acute asthma. Their exacerbation is often precipitated by a viral upper respiratory infection (URTI), but in some instances antibiotics are prescribed in spite of questionable efficacy. A lack of strong evidence either to support or to refute the use of treatments in acute asthma leaves room for discussion and debate as to how effective antibiotics are in an acute setting. This review assesses what evidence is available.


OBJECTIVE
To determine the efficacy of antibiotics prescribed in the treatment of acute asthma


METHODS
Electronic databases (MEDLINE, EMBASE and CINAHL) were searched to identify all possible randomised control trials.


METHODS
Only RCTs or quasi RCTs were eligible for inclusion. Studies were included if patients were treated for acute asthma in the ED or its equivalent with antibiotics or placebo. Two reviewers independently assessed articles for potential relevance, final inclusion, and methodological quality.


METHODS
Two reviewers completed trial quality assessment and data extraction independently.


RESULTS
From 128 potential studies, two trials were identified for inclusion in the review. Both trials reported numbers of exacerbations and not patient numbers due to re admissions over the course of the trials. The total number of patients in this review was 97, but values were recorded for 115 exacerbations.


CONCLUSIONS
The role of antibiotics in the treatment of acute asthma is difficult to assess from the current literature. Recommendations regarding antibiotic use in acute asthma will remain consensus driven until more research is conducted which includes larger numbers of patients.
Graham
V
V
51, Clancarty Road, London, UK, SW6 3AH.
Lasserson
T
T
Rowe
B H
BH
D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D006801:Humans; D016032:Randomized Controlled Trials as Topic
D000900:Anti-Bacterial Agents