It is known that antibiotics are used too often in people with acute lower respiratory infections (ALRTI). Lower respiratory infections include illnesses like acute bronchitis, pneumonia and lung abscesses, where an infection in one part of the lung causes a build-up of pus. We use 'acute' to mean a new illness that comes on quickly rather than an illness that patients have for weeks, months or longer. When a patient has one of these illnesses, they usually have shortness of breath, weakness, fever, coughing and extreme tiredness. We think that antibiotics may also be used too often to treat ALTRI in people with asthma. It might also be the case that doctors are using medicine for asthma to treat non-asthmatic patients with ALRTI. We would like to find out:
1. the patterns of antibiotics and asthma medication given to adults without asthma and young people with ALRTI.
2. whether adults and young people with asthma are more likely to get antibiotics for an ALRTI than people without asthma.
The information we find out will help us design a research study to lessen the amount of unnecessary antibiotics given to patients with asthma.
British Thoracic Society asthma guidelines recommend that treatment for acute lower respiratory tract infections (ALRTI) in asthmatics should be a 'step-up' in asthma-medication and not antibiotics. However, anecdotal evidence suggests that simultaneous prescriptions of antibiotics is extremely common, but little is known about the precise treatment patterns of ALRTI among asthmatics in primary care in the UK. We will investigate GPs prescribing patterns of antibiotics and asthma-medication in over 100,000 patients aged 12 years and older who were diagnosed with an ALRTI in 2014 and 2015. We will investigate whether asthmatics were more or less likely to be prescribed antibiotics compared to non-asthmatics. Multivariable regression will be used to model the association between asthmatic status and antibiotic and asthma-medication use. Furthermore, we will investigate whether practice (e.g. geographic), GP and patient-level (e.g. age, sex, and ALRTI and antibiotic prescription history) factors influence the association using mixed-effect regression models. Results from this study will provide an insight into the prescribing of antibiotics for ALRTI amongst asthmatics, and identify potential factors that may be associated with sub-optimal management. Findings will inform the development of a future intervention study to reduce the inappropriate use of antibiotics in patients with asthma.
Antibiotic prescription; Asthma medication prescription; No treatment.
Esther van der Werf-Kok - Chief Investigator - University of Bristol
Esther van der Werf-Kok - Corresponding Applicant - University of Bristol
Alastair Hay - Collaborator - University of Bristol
Rachel Denholm - Collaborator - University of Bristol
HES Admitted Patient Care;Patient Level Index of Multiple Deprivation