A survey study on antibiotic prescription practices for acute asthma exacerbations: An European academy of allergy and clinical immunology task force report.

Autor: Redel AL; Department of Pulmonology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.; Department of Pulmonology, Erasmus Medical Center, Rotterdam, The Netherlands., Feleszko W; Department of Pediatric Allergy and Pneumonology, Medical University of Warsaw, Warsaw, Poland., Arcolaci A; Immunology Unit, University of Verona and General Hospital Borgo Roma Hospital, Verona, Italy., Cefaloni F; Università Cattolica del Sacro Cuore, Rome, Italy., Atanaskovic-Markovic M; Faculty of Medicine, University of Belgrade, University Children's Hospital, Belgrade, Serbia., Braunstahl GJ; Department of Pulmonology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.; Department of Pulmonology, Erasmus Medical Center, Rotterdam, The Netherlands., Boccabella C; Faculty of Medicine and Surgery, Respiratory Medicine, Catholic University of the Sacred Heart, Milan, Italy., Bonini M; Department of Cardiovascular and Thoracic Sciences, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy.; National Heart and Lung Institute, Royal Brompton Hospital & Imperial College London, London, UK., Karavelia A; Department of Ear-Nose-Throat Surgery, General Hospital of Nafplio, Nafplio, Greece., Louwers E; General Practice, Gezondheidscentrum Berkel en Rodenrijs, Berkel en Rodenrijs, The Netherlands., Mülleneisen N; Asthma-Allergiezentrum Leverkusen, Leverkusen, Germany., O'Mahony L; Department of Medicine, School of Microbiology, APC Microbiome Ireland, National University of Ireland, Cork, Ireland., Pini L; Department of Clinical and Experimental Sciences, Respiratory Medicine Unit, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy., Rapiejko A; Department of Pediatric Allergy and Pneumonology, Medical University of Warsaw, Warsaw, Poland., Shehu E; Internal Medicine Department, Durres Regional Hospital, Durres, Albania., Sokolowska M; Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Zürich, Switzerland., Untersmayr E; Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria., Tramper-Stranders G; Department of Pulmonology, Erasmus Medical Center, Rotterdam, The Netherlands.; Department of Pediatrics, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Clinical and translational allergy [Clin Transl Allergy] 2024 Mar; Vol. 14 (3), pp. e12345.
DOI: 10.1002/clt2.12345
Abstrakt: Introduction: Guidelines recommend treating asthma exacerbations (AAEs) with bronchodilators combined with inhaled and/or systemic corticosteroids. Indications for antibiotic prescriptions for AAEs are usually not incorporated although the literature shows antibiotics are frequently prescribed.
Aim: To investigate the antibiotic prescription rates in AAEs and explore the possible determining factors of those practices.
Methods: A digital survey was created to determine the antibiotic prescription rates in AAEs and the influencing factors for the prescription practices. The survey was distributed among European academy of allergy and clinical immunology (EAACI) members by mass emailing and through regional/national societies in the Netherlands, Italy, Greece, and Poland. Furthermore, we retrieved local antibiotic prescription rates.
Results: In total, 252 participants completed the survey. Respondents stated that there is a lack of guidelines to prescribe antibiotics in AAEs. The median antibiotic prescription rate in this study was 19% [IQR: 0%-40%] and was significantly different between 4 professions: paediatrics 0% [IQR: 0%-37%], pulmonologists 25% [IQR: 10%-50%], general practitioners 25% [IQR: 0%-50%], and allergologists 17% [IQR: 0%-33%]) (p = 0.046). Additional diagnostic tests were performed in 71.4% of patients before prescription and the most common antibiotic classes prescribed were macrolides (46.0%) and penicillin (42.9%). Important clinical factors for health care providers to prescribe antibiotics were colorised/purulent sputum, abnormal lung sounds during auscultation, fever, and presence of comorbidities.
Conclusion: In 19% of patients with AAEs, antibiotics were prescribed in various classes with a broad range among different subspecialities. This study stresses the urgency to compose evidence-based guidelines to aim for more rational antibiotic prescriptions for AAE.
(© 2024 The Authors. Clinical and Translational Allergy published by John Wiley & Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology.)
Databáze: MEDLINE
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