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Experts advise against prescribing unnecessary antibiotics for asthma


Paul Hayes


12/11/2018 1:50:00 PM

As the two-year anniversary of the Melbourne thunderstorm asthma event approaches, specialists have cautioned against prescribing antibiotics to children with severe asthma symptoms.

Paediatric respiratory specialist Assoc Prof Nitin Kapur recommends prescribing antibiotics for severe symptoms of asthma when there is ‘strong evidence of fever or pneumonia’.
Paediatric respiratory specialist Assoc Prof Nitin Kapur recommends prescribing antibiotics for severe symptoms of asthma when there is ‘strong evidence of fever or pneumonia’.

The warning coincides with World Antibiotic Awareness Week, a World Health Organization (WHO) initiative that aims to increase awareness of antibiotic resistance and encourage best practices among the public, healthcare workers and policy makers.
 
‘The unnecessary prescription of antibiotics is a serious issue that needs to be addressed if we are to avoid the development of antibiotic-resistant bacteria,’ paediatric respiratory specialist Associate Professor Nitin Kapur said. ‘To do this, doctors need to avoid prescribing antibiotics for conditions where there is no evidence of their efficacy.
 
‘There is currently no evidence that antibiotics reduce the severity of symptoms associated with exacerbations of asthma in children.’
 
Associate Professor Kapur recommends only prescribing antibiotics for children with severe symptoms of asthma in the event there is ‘strong evidence of fever or pneumonia’. 
 
Paediatric-focused recommendations
The Thoracic Society of Australia and New Zealand (TSANZ) has also released its top five low-value practices and interventions:

  1. Do not prescribe combination therapy (inhaled corticosteroids with long-acting beta2 agonist) as initial therapy in mild to moderate asthma before a trial of inhaled corticosteroids alone
  2. Do not prescribe antibiotics for exacerbation of asthma
  3. Do not use oral beta2-agonists as bronchodilators in asthma, wheeze or bronchiolitis
  4. For children with bronchiolitis without other comorbidities, do not delay discharge from an inpatient admission based on oxygen saturations alone if saturations are ≥90%
  5. Do not delay immunisation(s) based on presence of mild respiratory symptoms in the absence of fever



antimicrobial asthma thunderstorm asthma World Antibiotic Awareness Week





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