Specialists have today released new medical advice warning against prescribing antibiotics to children with severe asthma symptoms.

The advice, released during World Antibiotic Awareness Week, is one of five paediatric-focused recommendations released today by the Thoracic Society of Australia and New Zealand (TSANZ) as part of the Royal Australasian College of Physician’s (RACP) Evolve initiative.

Associate Professor Nitin Kapur, a paediatric respiratory specialist and RACP Fellow, said:

“The unnecessary prescription of antibiotics is a serious issue that needs to be addressed if we are to avoid the development of antibiotic resistant bacteria. To do this, doctors need to avoid prescribing antibiotics for conditions where there is no evidence of their efficacy.”

“There is currently no evidence that antibiotics reduce the severity of symptoms associated with exacerbations of asthma in children.

“In addition to its lack of effectiveness, children on long-term antibiotic treatment as well as those taking frequent short courses, may be at an increased risk of bacterial resistance and other adverse effects.

“We recommend against prescribing antibiotics for children with severe symptoms of asthma unless there is strong evidence of fever or pneumonia.”

The recommendation is supported by the 2018 Global Initiative for Asthma Report.

There is some evidence that azithromycin may potentially reduce the duration of asthma-like symptoms in children less than 3 years of age with pre-school wheeze, but further research is needed.

The Evolve initiative is led by physicians and the Royal Australasian College of Physicians (RACP) to drive high-value, high-quality care in Australia and New Zealand. Evolve identifies a specialty's Top 5 clinical practices that, in particular circumstances, may be overused, provide little or no benefit or cause unnecessary harm. By developing and implementing strategies, the Evolve initiative supports physicians to change clinical behaviour, decision-making and reduce low-value care.

The list of five recommendations released today as part of World Antibiotics Awareness Week can be found here: https://evolve.edu.au/published-lists/thoracic-society-of-australia-and-new-zealand-paediatrics

To view the Evolve Top Five Lists and implementation resources, visit: https://evolve.edu.au.