Table 1.
Trimethoprim-sulfamethoxazole use in children with asthma is associated with improved FEV1 and reduced ED visits.
| Baseline/Follow up PFT cohort | Total cohort | ||||||
|---|---|---|---|---|---|---|---|
| TMP-SMX (n=24) | Clindamycin (n=41) | p-value | TMP-SMX (n=144) | Clindamycin (n=202) | p-value | ||
| Demographics | |||||||
| Age | |||||||
| Mean in years (+/− SEM) | 10.7 (0.86) | 11.2 (0.63) | 0.59 | 10.6 (0.44) | 10.7 (0.33) | 0.73 | |
| Biologic sex, n (%) | |||||||
| Male | 10 (42%) | 25 (61%) | 0.20 | 68 (47%) | 107 (53%) | 0.33 | |
| Female | 14 (58%) | 16 (39%) | 76 (53%) | 95 (47%) | |||
| Race, n (%) | |||||||
| Caucasian | 18 (75%) | 21 (51%) | 0.16 | 101 (70%) | 122 (60%) | 0.09 | |
| African American | 5 (21%) | 18 (44%) | 40 (28%) | 76 (38%) | |||
| Other/declined | 1 (4%) | 2 (5%) | 3 (2%) | 4 (2%) | |||
| Indication, n (%) | |||||||
| ENT | 7 (29%) | 7 (17%) | 0.02 | 26 (18%) | 51 (25%) | 0.03 | |
| Urologic | 6 (25%) | 1 (2%) | 44 (31%) | 1 (<1%) | |||
| SSTI | 9 (37%) | 24 (59%) | 71 (49%) | 134 (66%) | |||
| Respiratory | 2 (8%) | 9 (22%) | 3 (2%) | 16 (8%) | |||
| Asthma therapy, n (%) | |||||||
| No controller | 3 (13%) | 6 (15%) | 0.99* | 75 (52%) | 87 (43%) | 0.09 | |
| Inhaled corticosteroid | |||||||
| Low-dose ICS | 9 (37%) | 11 (27%) | 0.49 | 28 (19%) | 47 (23%) | 0.51 | |
| Medium ICS | 3 (13%) | 7 (17%) | 4 (3%) | 14 (6%) | |||
| High-dose ICS | 9 (37%) | 17 (41%) | 39 (27%) | 54 (27%) | |||
| Systemic steroid | 1 (4%) | 2 (5%) | 0.99* | 1 (<1%) | 2 (<1%) | 0.99* | |
| Biologic | 1 (4%) | 3 (7%) | 0.99* | 1 (<1%) | 3 (1%) | 0.64* | |
| Spirometry | Emergency Department Visits | ||||||
| Days from baseline spirometry to antibiotics Mean (+/−SE) | 177 (+/−43) | 194 (+/−26) | 0.71* | Total ED visits | |||
| 12 months prior | 60 | 71 | 0.04 | ||||
| 12 months after | 32 | 66 | |||||
| Days from antibiotics to follow up spirometry Mean (+/−SE) | 164 (+/−33) | 131 (+/−19) | 0.36* | Change in ED visits after antibiotics | |||
| Fewer | 22 (15.1%) | 28 (13.9%) | 0.05 | ||||
| Escalation in therapy n (%) | 2 (8%) | 6 (15%) | 0.70 | Same | 6 (4.2%) | 10 (5.0%) | |
| More | 9 (6.3%) | 32 (15.8%) | |||||
| De-escalation in therapy n (%) | 1 (4%) | 3 (7%) | 0.99 | None | 107 (74.3%) | 132 (65.3%) | |
| FEV1 Mean (95% CI) | |||||||
| Baseline | 90.3 (82.8-97.9) | 93.6 (89.3-98.5) | 0.42 | ||||
| Follow-up | 96.4 (89.5-103) | 93.3 (88.6-98.1) | 0.44 | ||||
| Change | 6.04 (2.4-9.7) | −0.56 (−2.8-1.7) | 0.002, 0.001‡ | ||||
| FVC Mean (95% CI) | |||||||
| Baseline | 97.8 (91.0-104.5) | 102.3 (97.4-107.1) | 0.29 | ||||
| Follow-up | 102.5 (96.6-108.3) | 101.4 (96.2-106.5) | 0.78 | ||||
| Change | 4.71 (0.96-8.5) | −0.93 (−3.1-1.3) | 0.006, 0.001‡ | ||||
| FEV/FVC Mean (95% CI) | |||||||
| Baseline | 81.3 (77.5-85.1) | 80.4 (77.8-83.0) | 0.68 | ||||
| Follow-up | 82.6 (79.2-86.0) | 80.7 (78.1-83.4) | 0.78 | ||||
| Change | 1.33 (−1.4-4.1) | 0.34 (−1.3-1.9) | 0.49, 0.335‡ | ||||
| FEF25-75 Mean (95% CI) | |||||||
| Baseline | 79.8 (61.9-97.7) | 83.2 (72.4-94.0) | 0.46 | ||||
| Follow-up | 83.1 (69.5-96.8) | 75.4 (67.7-83.1) | 0.38 | ||||
| Change | 4.35 (−8.8-17.5) | −7.80 (−17.4-1.8) | 0.13, 0.065‡ | ||||
Categorical variables analyzed via Chi-square test or Fisher’s exact test (for analyses with n<5, denoted by *).
Continuous variables analyzed by unpaired t-test unless noted otherwise.
‡
denotes multivariable linear regression analysis.