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[Acute bronchitis in adults. Clinical findings, microorganisms and use of antibiotics]

H Melbye1, B P Berdal

  • 1Institutt for samfunnsmedisin Universitetet i Tromsø.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|March 10, 1994
PubMed

Insights

Identifying acute bronchitis causes is key. Certain patients benefit from antibiotics, with erythrocyte sedimentation rate and C-reactive protein tests aiding diagnosis.

Area of Science:

  • Infectious Diseases
  • Respiratory Medicine
  • Clinical Microbiology

Context:

  • Acute bronchitis is a common respiratory illness, often presumed viral, leading to varied treatment approaches.
  • Distinguishing bacterial from viral acute bronchitis is challenging, impacting antibiotic stewardship.
  • Current diagnostic methods for identifying specific pathogens in acute bronchitis are not always employed.

Purpose:

  • To investigate the aetiology of acute bronchitis in adult patients.
  • To determine the utility of clinical signs, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in identifying patients requiring antibiotic treatment.
  • To correlate specific pathogens with clinical presentation and inflammatory markers.

Summary:

  • Serological investigation identified an aetiologic agent in 40% of 72 adult acute bronchitis patients, with influenza virus being most common.
  • Bacterial infections (pneumococci, Mycoplasma pneumoniae) and radiographic pneumonia were found in 11 patients.
  • Elevated CRP and ESR levels were significantly higher in patients with bacterial infection or pneumonia, distinguishing them from those with viral or unspecified bronchitis. Wheezing was less common in the bacterial/pneumonia group.

Impact:

  • Findings suggest that specific biomarkers, namely CRP and ESR, can aid clinicians in identifying acute bronchitis patients who may benefit from antibiotic therapy.
  • This research supports a more targeted approach to antibiotic prescribing in acute bronchitis, potentially reducing unnecessary antibiotic use.
  • The study highlights the importance of considering bacterial aetiologies and pneumonia in a subset of acute bronchitis cases.

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