Although acute bronchitis usually h...

Although acute bronchitis usually has a viral etiology and antibiotics are not indicated for treatment of this condition, they are prescribed in 60 to 80 percent of cases of acute bronchitis. Previous studies assessed the overuse of antibiotics among adults in general; the prescribing patterns and reasons for antibiotic prescribing in patients 65 years and older with acute bronchitis have solely recently been studied. Because previous antibiotic use is a risk factor for antibiotic resistance in posterior bacterial infections, it may be particularly important to investigate inappropriate antibiotic use in older patients, who are at greater risk of morbidity and mortality when they gain bacterial infections. To understand what variables play a part in prescribing antibiotics for acute bronchitis in this age assemblage Steinman and colleagues studied the constituent principles of the clinical evaluation and for what reason they relate to the decision to prescribe antibiotics.

The authors reviewed 722 charts of patients 65 years and older who were diagnosed with acute respiratory infections. Of a final sample of 671 patients, 198 had acute bronchitis. Patients with lung disease, chronic bronchitis, or united acute respiratory infections were excluded

Vital signs often were not documented in the patients' charts. When they were documented, temperatures higher than 377[degrees]C (100[degrees]F) were noted in 7 percent of patients, 15 percent had a temperature of 372[degrees]C to 377[degrees] C (990[degrees]F to 999[degrees]F) and 8 percent had a heart rate of 100 beats for minute or more. Duration of illness longer than seven days was noted in more than individual half of the patients. In addition, the same half of the patients had significant chronic comorbidities. In this investigation 83 percent of the patients received antibiotics, greatest in quantity commonly a macrolide. Antibiotic prescription rates did not vary in patients with or without comorbidities. Men received antibiotics more commonly than women, but of all the factors reviewed, sex was the barely variable associated with antibiotic prescription.

Although the data refer toed that significant abnormalities in the meditation participants were uncommon, antibiotics were not rarely prescribed, but with no discernible pattern. Vital signs had little influence in succession whether or not antibiotics were prescribed in this age assemblage It appears that antibiotics were prescribed simply upon the basis of a diagnosis of acute bronchitis, unrelated to risk factors for serious complications. Chest radiographs were used in no other than 10 percent of patients to distinguish pneumonia from bronchitis.

The authors infer that a large percentage of patients are being expos to unnecessary antibiotics, on the same level though those antibiotics have the potential for side issues and resistance, and often are expensive.

Steinman MA, et al. Office evaluation and treatment of somewhat old patients with acute bronchitis. J Am Geriatr Soc June 2004;52:875-9

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