Antibiotics don’t help recovery from asthma. A new study followed about 200 people who presented with asthma attacks, and allowed half of them to be put on an antibiotic (azithromycyin, or Zithromax), in addition to the usual asthma meds that open the airways. This is on the theory that a bacterial infection provoked the asthma. There is also a theory that antibiotics help quiet lung inflammation. But they found that those on antibiotics didn’t get better any faster, and were more likely to suffer drug side effects.
In order to do the study, researchers screened 4582 patients. They rejected over 2000 of them because their doctors had already put them on antibiotics. In fact 73% of office visits for asthma involve getting an antibiotic prescription. The new study shows that most of those are unnecessary.
Aside from asthma, the Centers for Disease Control (CDC) estimates that approximately 50% of antibiotic prescriptions written in the doctor’s office – for any medical condition – are unnecessary. 5 prescriptions per year are written for every 6 people in the whole country, or 263 million courses of antibiotcs.
Is it better to take an antibiotic “just in case” and cover all bases? Not if you look at the drug side effects. One in every 15 people is allergic to an antibiotic. Azithromycin, the drug in the asthma study, stresses the liver, and this may progress to liver failure. Like all antibiotics, it can cause antibiotic-associated colitis due to killing off good bacteria and allowing drug resistant Clostridium difficile bacteria to overgrow. Some the nastier side effects of azithromycin are upset stomach and diarrhea, and these mental effects:
- behavioral changes
- manic behavior
Newer research shows the degree of antibiotic use in childhood correlates with those same persons having diabetes and obesity as adults.
Antibiotics should only be prescribed if there is a culture-proven infection (with a bacteria growing in the lab), or if there is a very strong suspicion of an actual bacterial infection and lack of treatment would be life-threatening.
Tip for the smart consumer: Question the need for every prescription you are handed. Find out the details of antibiotic effects in No-Nonsense Guide to Antibiotics: Dangers, Benefits, and Proper Use by Moira Dolan MD
JAMA Intern Med. 2016;176(11):1630-1637.
Get Smart About Antibiotics – Measuring Outpatient Prescribing. The CDC, 2015
The Numbers Behind Antibiotic Overuse – NEJM Journal Watch