Antibiotic prescribing for acute bronchitis

ABSTRACT

Introduction: Acute bronchitis is a self-limiting infectious disease characterized by acute cough with or without sputum but without signs of pneumonia. About 90% of cases are caused by viruses.

Areas covered: Antibiotics for acute bronchitis have been associated with an approximately half-day reduction in duration of cough. However, at follow-up there are no significant differences in overall clinical improvement inpatients treated with antibiotics compared with those receiving placebo. Despite this, antibiotics are administered to approximately two thirds of these patients. This review discusses the reason for this antibiotic overprescription. Other therapies targeted to control symptoms have also demonstrated a marginal or no effect.

Expert commentary: Clinicians should be aware of the marginal effectiveness of antibiotic therapy. Some strategies like the use of rapid tests, delayed prescribing of antibiotics and the use of leaflets for patients have been associated with a reduction of their unnecessary utilization.

KEYWORDS:

• Acute bronchitis
• acute cough
• antibiotics
• treatment

Declaration of interest

C Llor has received a grant from the Fundació Jordi Gol i Gurina for a research stage at the University of Cardiff. He also reports receiving research grants from the European Commission (Sixth & Seventh Programme Frameworks and Horizon 2020), Catalan Society of Family Medicine, and Instituto de Salud Carlos III. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.