by Playfuls Staff |
17th November 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.
[more]
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.
