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Clinical Study About Antibiotics & BronchitisDespite the findings in controlled trials that antibiotics provide limited benefit in the treatment of acute bronchitis, physicians frequently prescribe antibiotics for acute bronchitis. The aim of this study was to determine whether certain patient or provider characteristics could predict antibiotic use for acute bronchitis in a system where antibiotic use had already been substantially reduced through quality-improvement efforts. Methods: A retrospective chart review was performed in an academic family medicine training center that had previously instituted a quality-improvement project to reduce antibiotic prescribing for acute bronchitis. Patients who had acute bronchitis diagnosed during an 18-month period and who had no other secondary diagnosis for respiratory distress or a condition that would justify antibiotics were selected from a computerized-record database and included in the study (n = 135). Charts were reviewed to document patient symptoms, physical findings, provider and patient characteristics, and treatment. Results: Thirty-five (26%) patients received antibiotics for their acute bronchitis. Adults were more likely to receive antibiotics than children (34% vs. 3%, P < .001). Analysis of 20 different symptoms and physical findings showed that symptoms and signs were poor predictors of antibiotic use. Likewise, no significant differences were found based on prescribing habits of individual providers or provider level of training. Conclusion: In a setting where antibiotic use for acute bronchitis had been decreased through an ongoing quality-improvement effort, it did not appear that providers selectively used antibiotics for patients with certain symptoms or signs. Other factors, such as no clinical cues, might drive antibiotic prescribing even after clinical variation is suppressed. [J Am Board Fam Pract 13(6):398-402, 2000. © 2000 American Board of Family Practice]
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Michael Grant White, Breathing.com, Box 1551, Waynesville, NC, 28786 USA Toll-Free Phone: 866 MY INHALE (866 694 6425). International Phone: 001 828 456 5689. Copyright © 2003 Breathing.com. All rights reserved. | Terms & Conditions | Privacy Statement Opinions and recommendations presented on Breathing.com are intended to supplement, not replace, consultations with a qualified practitioner. |
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