Combining antibiotics and asthma drugs common practice for treating respiratory symptoms

Belgian researchers report that children who are taking asthma drugs are almost twice as likely to be prescribed antibiotics for episodes of wheezing, cough, and shortness of breath as children who are not. Additionally, more than one-third of these children are coprescribed an antibiotic on the same day.

Using a health care insurance database, researchers analyzed the common practice of codispensing antibiotics and asthma drugs for 892,841 children in the first study year and 880,969 in a second study year of validation. Study participants were divided into 3 groups: younger than 3 years, 3 to 7 years, and 8 to up to 18 years.

Each child was tracked individually. Overall, 73.50% of the children taking an asthma drug received an antibiotic during the same year versus 38.62% of children not taking an asthma drug. Moreover, 35.64% of children who were dispensed an asthma drug in the study year were dispensed an antibiotic on the same day. Data were nearly identical in both years of analysis.

The significantly higher dispensing rate for antibiotics to children taking an asthma drug in the same year was present across all age categories (P

“The [same-day] coprescription of antibiotics in one-third of all children who are prescribed an asthma drug is particularly hard to justify or understand,” the researchers say. When treating a child with respiratory symptoms, physicians should distinguish between children who have wheezing and shortness of breath that may be helped with an asthma drug and those with fever and signs of bacterial airway infection who would benefit from an antibiotic.

This practice, according to the researchers, would limit coprescription of asthma drugs and antibiotics to those cases that warrant it.

De Boeck K, Vermeulen F, Meyts I, Hutsebaut L, Franckaert D, Proesmans M. Coprescription of antibiotics and asthma drugs in children. Pediatrics. 2011. Epub ahead of print.