Extended antibiotic exposure and exacerbations, mortality, and healthcare costs in asthma.

Hyun Woo Lee, Kyungjoo Kim, Jung-Kyu Lee, Chin Kook Rhee, Kyung Hoon Min, Seong Yong Lim, Deog Kyeom Kim

Abstract read

In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

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0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Hyun Woo LeeDivision of Respiratory and Critical Care, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea.

Kyungjoo KimDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Jung-Kyu LeeDivision of Respiratory and Critical Care, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea.

Chin Kook RheeDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Kyung Hoon MinDivision of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea.

Seong Yong LimDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Deog Kyeom KimDivision of Respiratory and Critical Care, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea. kimdkmd@snu.ac.kr.

Funding

Korea Ministry of Environment 2022003310008

6 · The paper itself

Abstract

Asthma exacerbations contribute significantly to morbidity, mortality, and healthcare costs, with antibiotics commonly prescribed despite uncertain benefits and risks. This retrospective cohort study analyzed claim database between 2020 and 2022. Patients were categorized into extended (≥ 4 weeks) or limited (< 4 weeks) antibiotic exposure groups based on cumulative antibiotic use. We assessed the associations between prior antibiotic exposure and moderate-to-severe exacerbations, all-cause mortality, and total healthcare costs. We identified 549,425 adult asthma patients, classified into extended (25.2%) and limited (74.8%) antibiotic exposure groups. Extended antibiotic exposure was significantly associated with moderate-to-severe exacerbations (aOR = 1.25, 95% CI = 1.23-1.26) and nearly doubled the odds of all-cause mortality (aOR = 1.99, 95% CI = 1.92-2.07). Patients in the extended exposure group incurred significantly higher healthcare costs (median 7,433 vs. 5,471 thousand KRW, P < 0.001). A cumulative association pattern was observed, where longer durations of antibiotic use, greater cumulative doses, and exposure to multiple antibiotic classes were associated with progressively greater odds of exacerbations, mortality, and increased medical costs. Significant interactions revealed that rhinitis and sinusitis mitigated attenuated these associations, while bronchiectasis further strengthened them. Extended antibiotic use in adult asthma patients was linked to worse outcomes. However, as causality cannot be confirmed due to potential biases, further studies are needed.

Indexed as

Anti-Bacterial AgentsAsthmaHealth Care CostsAdultAgedDisease ProgressionFemaleHumansMaleMiddle AgedRetrospective StudiesAnti-Bacterial AgentsAnti-bacterial agentsAsthmaDrug-related side effects and adverse reactionsHealth care costsMortalitySymptom flare up

Identifiers

PMID41044157

DOI10.1038/s41598-025-12318-7

PMCPMC12494924

What OpenQuestion holds

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LicenceCC BY-NC-ND

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.