Antibiotics Unnecessarily Prescribed for Acute Bronchitis

Nov 16, 2006

Antibiotics are routinely prescribed unnecessarily for acute bronchitis, according to Virginia Commonwealth University findings published in today's issue of the New England Journal of Medicine.

Physicians for years have prescribed antibiotics for the treatment of acute bronchitis, a common condition caused by inflammation of the bronchi of the lungs that occurs in 5 percent of adults each year.

The VCU School of Medicine researchers concluded there is no evidence in current literature to support prescribing antibiotics for the treatment of short-term bronchitis as almost all the causes of such infections are viral and therefore don't respond to the therapy, according to the article.

Richard P. Wenzel, M.D., professor and chair in the Department of Internal Medicine at the VCU School of Medicine, and Alpha A. Fowler III, M.D., chair in the Division of Pulmonary Disease and Critical Care Medicine, conducted a critical review of the world literature. They examined research studies and clinical trials regarding acute bronchitis as they related to individuals, pathology, diagnosis, treatment strategies and any data supporting the potential benefits of anti-bacterial agents.

According to Wenzel, almost all the known causes of acute bronchitis are viral and are caused by organisms that have no known therapy and cannot be influenced by antibiotic treatment. Only a small percentage of acute bronchitis cases are caused by bacteria that physicians can treat, such as whooping cough. He said that approximately 70 percent to 80 percent of individuals are prescribed antibiotics for treatment lasting five to 10 days.

"As a community of medicine we have a habit of prescribing a lot of medication. There are many things we prescribe that are not based on evidence in the literature," Wenzel said. "Based on our review of the data in the literature, we are not practicing evidence-based medicine when it comes to the treatment of acute bronchitis."

In addition to little evidence supporting the effectiveness of antibiotics for the treatment of acute bronchitis, antibiotics can be expensive and may cause adverse side effects such as abdominal pain, diarrhea and rash that may require further treatment. Furthermore, induced resistance to antibiotics makes them less useful for treatment against other infections.

"There is a long history of patients receiving antibiotics for acute bronchitis and they have come to expect receiving a prescription for treatment. Physicians can help patients by not prescribing them antibiotics for acute bronchitis – saving them from potential side effects and unnecessary costs," Wenzel said.

"Physicians should inform their patients that there are no data in the literature to support the use of antibiotics for this condition," he said.

Wenzel and Fowler also examined the literature to determine what other medications patients are frequently prescribed. They found that although prescription cough medications are prescribed in almost 100 percent of acute bronchitis cases, the literature showed little evidence of any effect.

Source: Virginia Commonwealth University

Explore further: Rapivab approved to help treat flu

add to favorites email to friend print save as pdf

Related Stories

Pfizer says patient died in oral RA drug study

Apr 22, 2011

(AP) -- Pfizer Inc. confirmed that one patient who was taking its drug candidate tofacitinib, a pill designed to treat rheumatoid arthritis, died during a recent clinical trial and said the death was connected to the drug.

Healthy gums may lead to healthy lungs

Jan 18, 2011

Maintaining periodontal health may contribute to a healthy respiratory system, according to research published in the Journal of Periodontology. A new study suggests that periodontal disease may increase the risk for respir ...

Scientists open doors to diagnosis of emphysema

Aug 03, 2009

Chronic inflammatory lung diseases like chronic bronchitis and emphysema are a major global health problem, and the fourth leading cause of death and disability in developed countries, with smoking accounting for 90% of the ...

Recommended for you

Express Scripts turns to AbbVie in huge hepatitis C deal

13 hours ago

The nation's largest pharmacy benefits manager is throwing its weight into the fight over high-cost hepatitis C drugs with a coverage restriction that might ultimately lower prices and improve patient access ...

FDA OKs Cubist antibiotic for serious infections

Dec 20, 2014

The Food and Drug Administration has approved a new medicine to fight complex infections in the abdomen and urinary tract, the fourth antibiotic the agency has approved since May.

Xtoro approved for swimmer's ear

Dec 18, 2014

(HealthDay)—Xtoro (finafloxacin otic suspension) eardrops have been approved by the U.S. Food and Drug Administration to treat swimmer's ear, clinically known as acute otitis externa.

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.