Asthma exacerbations are characterized by decreased expiratory airflow as well as increased shortness of breath, cough, wheezing, chest tightness, or a combination of these symptoms. When such an attack is precipitated by an infection, it is much more likely to be viral than bacterial. The role of bacterial infection is often overestimated; however antibiotics should be reserved for relatively rare cases in which there is strong evidence of a bacterial infection, such as pneumonia or bacterial sinusitis. Potential harms of unnecessary antibiotic treatment include medication costs, side-effects (including a risk of allergy), and emergence of bacterial resistance.

Conditions: Asthma exacerbations, bacterial infection

Treatments: Antibiotics

Sources

• Aldington S, et al. Asthma exacerbations. 5: assessment and management of severe asthma in adults in hospital. Thorax. 2007 May;62(5):447-58. (PubMed)
• Bousquet J, et al. Uniform definition of asthma severity, control, and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. J Allergy Clin Immunol. 2010 Nov;126(5):926-38. (PubMed)
• British Thoracic Society / Scottish Intercollegiate Guidelines Network. BTS/SIGN British guideline on the management of asthma [Internet]. 2017 Apr [cited 2017 May 5]. Available from: https://www.brit-thoracic.org.uk/standards-of-care/guidelines/btssign-british-guideline-on-the-management-of-asthma/.
• Chung KF, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014 Feb;43(2):343-73. (PubMed)
• Schatz M, et al. Joint task force report: supplemental recommendations for the management and follow-up of asthma exacerbations. Introduction. J Allergy Clin Immunol. 2009 Aug;124(2 Suppl):S1-4. (PubMed)