Respiratory distress from bronchospasm/wheezing is a common presentation in both children (i.e., bronchiolitis) and adults (i.e., bronchitis/asthma) seen in the emergency department. Most patients with symptoms do not have bacterial infections that require antibiotic treatment or influence outcomes (i.e., hospitalization). Inappropriate administration of antibiotics can expose patients to unnecessary risks (i.e., allergies, rash, diarrhea and other side-effects) and has the potential to increase patients’ risk of antibiotic induced diarrhea, including infections with C. Difficile. These prescriptions also increase overall antibiotic resistance in the community, and limit the effectiveness of standard antibiotics in the treatment of legitimate bacterial infections. There is strong applied research evidence to recommend that physicians should not prescribe antibiotics in children (i.e., bronchiolitis) and adults (i.e., bronchitis and asthma) with wheezing presentations.
Sources:
Farley R, et al. Antibiotics for bronchiolitis in children under two years of age. Cochrane Database Syst Rev. 2014; 10:CD005189. PMID: 25300167.
Graham V, et al. Antibiotics for acute asthma. Cochrane Database Syst Rev. 2001; (3):CD002741. PMID: 11687022.
Smith SM, et al. Antibiotics for acute bronchitis. Cochrane Database Syst Rev. 2014; 3:CD000245. PMID: 24585130.
Related Resources:
Patient Pamphlet: Avoid Unnecessary Treatments in the ED: Talking with the doctor can help you make the best decision