Bronchitis and Antibiotics

A colleague has told me about some interesting data that people are far less likely to request an antibiotic for a chest cold than for bronchitis even though they’re the same thing. With that in mind, here’s something from the archives.

One cause of the evolution of antibiotic resistance is the inappropriate use of antibiotics in clinical practice. A recent study concluded that antibiotic therapy did not result in eliminate bronchitis any faster than not using the antibiotic:

A study found that bronchitis sufferers who are otherwise healthy do not get better any faster by taking antibiotics. “Antibiotics for the vast majority of people don’t seem to make much difference,” said Dr. Paul Little, author of the five-year study of patients in England. Moreover, many bronchitis cases are caused by viruses, which antibiotics do not fight.

Bronchitis is a highly common ailment. The findings suggest one major area where doctors can economize on the use of antibiotics. Overuse of antibiotics is believed to be contributing to the rise of dangerous drug-resistant strains of bacteria.

Little said that otherwise healthy patients can skip the drugs to treat the chest infections, even though they will feel crummy for a couple of weeks. But patients with conditions such as chronic lung and heart disease that can cause bronchitis to develop into pneumonia should see their doctors, he said.

In the study, coughing lasted an average of 11 days after patients saw their doctors, whether they got antibiotics or not. Other symptoms, such as phlegm and shortness of breath, were reduced by less than a day for people treated with amoxicillin or erythromycin.

“They all got better in the same time,” said Little, a professor of primary care research at the University of Southampton.

The study, based on 640 patients ages 3 and older, was published in Wednesday’s Journal of the American Medical Association. The study excluded patients with conditions that could complicate their bronchitis, such as asthma or heart and lung disease.

One study participant who did not receive antibiotics developed pneumonia and was hospitalized. The patient was treated with antibiotics and recovered fully.

“The findings of this study will probably surprise many clinicians and most patients,” Dr. Mark Ebell, an associate professor of family practice at Michigan State University and a family physician in Athens, Ga.

Don’t try to pressure your doctor into giving you antibiotics-it’s amazing how many clinicians experience this. It won’t make you any better, and will only make the antibiotic crisis-and it is a crisis-worse.

click here for the JAMA article.

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3 Responses to Bronchitis and Antibiotics

  1. apy says:

    Are most physicians educated in not giving antibiotics and the negative effects? In times like this I’m almost tempted to want to give the scared mother a placebo just because I know that if their physician won’t give them antibiotics they will go to one that will. Too bad really.

  2. Joshua says:

    It’s gotta be the “-itis”.

  3. mallen says:

    How often is bronchitis caused by something other than a virus? I’m curious because I had bronchitis a couple of years ago and was very sick for about a week (fever and a bad cough). I started getting better for a few days, then got sicker (102F fever and even more coughing). My doctor did give me antibiotics at that time and within three or four days, the fever went down. It took another ten days or so for the cough to get better. Is it possible that if I’d waited, I would have gotten better anyway? BTW, I didn’t ask for antibiotics.

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