Infection in exacerbations of asthma: views of different groups of practitioners

A questionnaire designed to elucidate views on the frequency of infection in asthma and its management was circulated to general practitioners, general physicians, paediatricians and respiratory physicians in the north of England. On the whole, general practitioners agreed with the general physicians and paediatricians with respiratory physicians. The generalists, and to a lesser extent the specialists, tended to overestimate the risk of bacterial infection, which was perceived to be a particular risk following viral infection in intrinsic asthma. This resulted in more frequent prescription of antibiotics than is justified by the published evidence. There was a tendency for frequent prescribers of antibiotics to withhold corticosteroids. If prescribing habits are to be altered, education will have to be directed at those responsible for acute admissions to hospital as well as at general practitioners.