Forty-four children and adolescents with status asthmaticus and without signs of bacterial infection, such as otitis media, purulent pharyngitis or lobular pulmonary infiltrate and fever were treated identically except that one group received hetacillin, whose active form is ampicillin, and one group received placebo in a prerandomized double-blind fashion. The groups were similar in terms of age, size and severity of asthma. Hospital course, complications and duration of hospitalization were similar for the two groups. The incidence of viral and mycoplasma infection was 20%. History, physical examination and chest x-ray were poor predictors of those with nonbacterial infection. There was no culture evidence that bacterial disease had been missed. It appears that the use of broad spectrum antibiotics such as hetacillin or ampicillin in children and adolescents with status asthmaticus and without clinical evidence of bacterial disease is of no benefit. The need for close observation of these patients is stressed.
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Shapiro et al. (1974) studied this question.