Antibiotics Unnecessarily Prescribed for Acute Bronchitis

November 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: Study shows inappropriate antibiotic prescribing differs by patient age, insurance, race

Related Stories

Study shows inappropriate antibiotic prescribing differs by patient age, insurance, race

January 30, 2018
A patient's age and race are associated with risk of receiving an unneeded antibiotic prescription for upper respiratory conditions caused by viruses, according to a study published today in Infection Control & Hospital Epidemiology, ...

New therapeutic approach for advanced lung disease

January 15, 2018
Researchers have demonstrated the potential of a new class of drugs for the treatment of refractory chronic obstructive pulmonary disease (COPD). Incurable to date, the disease is one of the most frequent causes of death ...

The U.S. may be in for a tough flu season—4 questions answered

December 20, 2017
This year, Australia suffered a record number of flu infections. This has some experts concerned that the U.S. will suffer a harsh flu season as well. Irena Kenneley, associate professor of nursing at Case Western Reserve ...

Chronic bronchitis new insights could lead to first diagnostic test and better treatments

September 6, 2017
When a patient arrives at a doctor's office with a persistent cough and the sensation of gunk building up in the lungs, the doctor's thought process is essentially the same as it would have been decades ago. There has been ...

Patient expectations of acute bronchitis not consistent with the best evidence

January 14, 2013
New research from the University of Georgia exposes a large discrepancy in the length of time patients expect an acute cough illness, also called acute bronchitis, to last and the reality of the illness. This mismatch may ...

Decision support reduces antibiotic usage for bronchitis

January 15, 2013
(HealthDay)—Decision support strategies can help reduce the over-prescription of antibiotics for acute bronchitis in primary care settings, according to a study published online Jan. 14 in JAMA Internal Medicine.

Recommended for you

Complex inhalers prevent patients from taking medicine

February 23, 2018
Respiratory disease patients with arthritis could struggle to manage their conditions because their inhalers are too fiddly for them to use, University of Bath research has found.

Opioid abuse leads to heroin use and a hepatitis C epidemic, researcher says

February 22, 2018
Heroin is worse than other drugs because people inject it much sooner, potentially resulting in increased risk of injection-related epidemics such as hepatitis C and HIV, a Keck School of Medicine of USC study shows.

Opioid addiction treatment behind bars reduced post-incarceration overdose deaths in RI

February 14, 2018
A treatment program for opioid addiction launched by the Rhode Island Department of Corrections was associated with a significant drop in post-incarceration drug overdose deaths and contributed to an overall drop in overdose ...

Heroin vaccine blocks lethal overdose

February 14, 2018
Scientists at The Scripps Research Institute (TSRI) have achieved a major milestone toward designing a safe and effective vaccine to both treat heroin addiction and block lethal overdose of the drug. Their research, published ...

Study shows NIH spent >$100 billion on basic science for new medicines

February 12, 2018
Federally funded research contributed to the science underlying all new medicines approved by the FDA over the past six years, according to a new study by Bentley University.

Opioid use increases risk of serious infections

February 12, 2018
Opioid users have a significantly increased risk of infections severe enough to require treatment at the hospital, such as pneumonia and meningitis, as compared to people who don't use opioids.

0 comments

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.