TY - T1的抗生素治疗哮喘发作:马斯king uncertainty JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00183-2021 VL - 58 IS - 1 SP - 2100183 AU - Ramakrishnan, Sanjay AU - Couillard, Simon Y1 - 2021/07/01 UR - //www.qdcxjkg.com/content/58/1/2100183.abstract N2 - The role for antibiotics in acute asthma has been historically overestimated [1]. From a mechanistic point of view, multiplex PCR testing and conventional microbiological techniques show that >50–80% of events are associated with viral infections, and less than 20% associated with evidence of bacterial infection, with the remaining proportion presumed to be due to allergies and irritants [2]. Consequently, antibiotics are not expected to work in the context of most asthma attacks and their routine use is not recommended. This stance is supported by a Cochrane review, which found inconsistent data to support antimicrobial use [3] and a good quality retrospective cohort study, which associated the combination of antibiotics and oral corticosteroids (OCS) with a longer hospital length of stay, higher hospital cost, and similar risk of treatment failure compared to matched patients treated only with OCS alone [4].Despite current guidelines advising against, GPs commonly prescribe antibiotics with steroids for asthma attacks. The uncertainty caused by a symptom-based management paradigm probably drives this. A biology-guided management paradigm is needed. https://bit.ly/3iS3CCdThe authors thank Ian Pavord for his time and insight during manuscript preparation. ER -