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Factors associated with antibiotic use for acute bronchitis
R Gonzales1, P H Barrett, L A Crane
1Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver 80262, USA.
Journal of General Internal Medicine
|September 12, 1998
Summary
Antibiotics are frequently prescribed for acute bronchitis in outpatient settings, despite limited evidence supporting their use. Clinical factors associated with antibiotic treatment play a minor role in this overprescription.
Area of Science:
- Primary Care Medicine
- Infectious Diseases
- Clinical Practice Research
Background:
- Acute bronchitis is a common respiratory illness encountered in primary care.
- Antibiotic use for acute bronchitis is a subject of debate due to its typically viral etiology.
Purpose of the Study:
- To characterize the clinical presentation of acute bronchitis in adults.
- To identify clinical predictors associated with antibiotic prescribing for acute bronchitis.
Main Methods:
- Prospective cohort study involving adult patients with acute respiratory illnesses.
- Data collected from clinicians in primary care office practices.
- Encounter forms completed for 1,525 patients diagnosed with acute bronchitis.
Main Results:
- Cough (92%) and phlegm production (63%) were the most common symptoms.
- Antibiotics were prescribed in 85% of acute bronchitis cases.
- Purulent nasal discharge and sinus tenderness showed a moderate association with antibiotic treatment.
Conclusions:
- Acute bronchitis is frequently treated with antibiotics in ambulatory care.
- Identified clinical factors have a limited impact on explaining the high rate of antibiotic use.
- Clinicians may be using the diagnosis of acute bronchitis as a proxy for antibiotic indication, contrary to guidelines.