[Diagnostic and therapeutic strategies in exacerbations of chronic bronchitis in city practice].
The consensus conference convened by the French Language Society for Infectious Disease at Lille in 1991 stressed the fact that two germs were most often the cause of exacerbation in chronic bronchitis (Streptococcus pneumoniae and Haemophilus influenzae) and that antibiotic therapy was the "safe solution" and that the first intention treatment should be either penicillin A, a first generation cephalosporin or a macrolide for the first 8-10 days. A chest x-ray was recommended if there was the slightest doubt about co-existing parenchymal disease with a reevaluation around the 7th day and a prescription of penicillin A plus a beta-lactamase inhibitor or a second or third generation cephalosporin in case of failure. The aim of this study was to assess the diagnostic and therapeutic attitudes of general practitioners when faced with exacerbation in chronic bronchitis in an adult of 60 without severe signs and to find out the antibiotic of first choice and also the antibiotic to be used if the first treatment failed. One hundred doctors were drawn at random from a list of general practitioners in Bordeaux. They were requested to reply to a questionnaire on the strategy of first choice antibiotic and the means of reassessment of the treatment after it had been instituted and the strategy used when faced with a patient who did not improve after the initial treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001991:Bronchitis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D002511:Cephalosporins / Q000627:therapeutic use; D002908:Chronic Disease; D005100:Expectorants / Q000627:therapeutic use; D005194:Family Practice; D006192:Haemophilus Infections / Q000188:drug therapy; D006193:Haemophilus influenzae; D006801:Humans; D018942:Macrolides; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D011008:Pneumococcal Infections / Q000188:drug therapy; D011795:Surveys and Questionnaires; D065093:beta-Lactamase Inhibitors
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D002511:Cephalosporins; D005100:Expectorants; D018942:Macrolides; D010406:Penicillins; D065093:beta-Lactamase Inhibitors
Stratégies diagnostiques et thérapeutiques devant les surinfections de bronchite chronique en pratique de ville.