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Research Letter | Less Is More

Use of Antibiotics Among Patients Hospitalized for Exacerbations of Asthma

Peter K. Lindenauer, MD, MSc1,2,3; Mihaela S. Stefan, MD, PhD1,2,3; Laura C. Feemster, MD, MS4,5; Meng-Shiou Shieh, PhD1; Shannon S. Carson, MD6; David H. Au, MD, MS4,5; Jerry A. Krishnan, MD, PhD7
[+] Author Affiliations
1Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts
2Division of Hospital Medicine, Baystate Medical Center, Springfield, Massachusetts
3Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts
4Veterans Affairs Health Services Research and Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, Washington
5Division of Pulmonary and Critical Care, University of Washington, Seattle
6Division of Pulmonary and Critical Care, University of North Carolina, Chapel Hill
7Population Health Sciences Program, University of Illinois Hospital and Health Sciences System, Chicago
JAMA Intern Med. 2016;176(9):1397-1400. doi:10.1001/jamainternmed.2016.4050.
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This study uses medical record data from Premier Alliance to describe the receipt, type, and timing of antibiotic therapy in patients with asthma in 2013 and 2014.

The Centers for Disease Control and Prevention estimates that 37% of all antibiotic use in hospitals may be inappropriate, and reducing unnecessary antibiotic prescribing is now considered an urgent national priority.1,2 In the United States alone, asthma exacerbations led to 1.8 million emergency department visits and 400 000 hospitalizations annually.3 Although guidelines recommend against prescribing antibiotics during exacerbations of asthma in the absence of concurrent infection, little is known about the use of antibiotics in routine clinical practice.4,5

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Figure.
Antibiotic Prescribing Rates Across Hospitals Included in the Study

Analysis was limited to 421 hospitals with at least 25 cases of asthma during the study period. Error bars indicate 95% CIs.

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