[Rational use of antibiotics treatment in acute bronchitis]

Acute bronchitis in healthy patient in mainly related to virus. Intra-cellular bacteria, Mycoplasma pneumonia are rarely involved. For these reasons, macrolides or cyclines (except for children) are justified in first line treatment. For patients with acute exacerbation of chronic bronchitis, the choice of the treatment needs to be discuss. At the initial stage, most of the pathogens involved are those of acute bronchitis. Antibiotic is only prescribes for the prevention of a superinfection; this kind of prophylaxis has to be evaluated. Few days after, histological due to modifications of bronchi, a superinfection can occur which needs a curative treatment. In most of the data reported the literature, there is no distinction between the two periods of the disease. It is interesting to point out that associated treatments such as kinesitherapy, corticosteroids can modify the natural course of bronchitis. There are not evaluated as associated treatment in the different clinical trials.