Antibiotics Over Prescribed in Asthmatic Children

Antibiotics are often prescribed with antiasthma drugs when they may not be required.

Respiratory tract infections that lead to wheezing in children are often a result of viral infection and do not warrant the use of antibiotics. Adding an antibiotic to the treatment regimen not only increases the cost of treatment but it also runs the danger of making bacteria resistant to the antibiotic. This could result in future ineffectiveness of the antibiotic.

Antibiotics should be used judiciously only after a culture and sensitivity test. In serious cases where one cannot wait for the results of the test, blood or other samples should be collected and sent for testing. Following this, an antibiotic that acts against a large number of bacteria or a broad spectrum antibiotic should be administered to the patient. Once the result of the culture and sensitivity test is obtained, the antibiotic should be changed to one that the bacteria are specifically sensitive to.

Asthma patients usually do not require antibiotics unless they develop respiratory tract infection. A study was conducted in Belgium to understand the use of antibiotics with antiasthma drugs in children with asthma. The study was conducted over 2 years. The authors found that there was a 3.12% decrease in the use of antibiotics in asthmatic children in the second year. During the second year, it was observed that 73.50% children on asthma drug received an antibiotic in the same year and 38.62% children received an antibiotic without an asthma drug during the same year. More importantly, about a third of the children were dispensed an antibiotic with an antiasthma drug on the same day.

Among the antibiotics, penicillins were most commonly prescribed followed by macrolides and cephalosporins. The cost of treatment was also high with the use of additional antibiotics.

The authors also deduced from the study that nebulization is overused in young children, and DPI and automatic inhalers are underused in older children.

Asthma Management
Metered Dose Inhalers(MDI), which delivers medictions directly to the lungs, can be most effectively used in the treatment of asthma.

The authors suggest that education of clinicians to reduce co prescription of antiasthma drugs and antibiotics unless necessary may help to reduce the use of antibiotics in children.

Reference:

Drug Resistance – Antibiotic or Antimicrobial Resistance
Drug resistance is often a problem in malaria, tuberculosis, HIV, sexually transmitted diseases and hospital acquired diseases. Judicious use of antibiotics can control the problem.

1. De Boeck K, Vermeulen F, Meyts I, Hutsebaut L, Franckaertc D, Proesmans M. Coprescription of Antibiotics and Asthma Drugs in Children. Pediatrics doi: 10.1542/peds.2009-3068.

Source-Medindia