title: Does drug treatment of patients with acute bronchitis reduce additional care seeking? Evidence from the Practice Partner Research Network.
abstract: BACKGROUND
  Considerable discussion has focused on treatment methods for patients with acute bronchitis.
  
  
  OBJECTIVE
  To examine whether antibiotic or bronchodilator treatment is associated with differences in follow-up visit rates for patients with acute bronchitis.
  
  
  METHODS
  A retrospective medical chart review was conducted for patients with a new episode of acute bronchitis over a 3-year period in the Practice Partner Research Network (29,248 episodes in 24,753 patients). Primary outcomes of interest were another visit in the next 14 days (early follow-up) or 15 to 28 days after initial treatment (late follow-up).
  
  
  RESULTS
  Antibiotics were used more commonly in younger patients (<18 years), whereas older patients (>65 years) were more likely to receive no treatment. Younger patients treated with antibiotics were less likely to return for an early follow-up visit, but no differences were seen in adults and older patients. Late follow-up rates were not affected by the initial treatment strategy. When patients did return for a follow-up visit, no new medication was prescribed to most (66% of younger patients and 78% of older adults). However, compared with patients who did not receive an antibiotic at their first visit, patients initially treated with an antibiotic were about 50% more likely to receive a new antibiotic at their second visit.
  
  
  CONCLUSIONS
  Initial prescribing of an antibiotic reduces early follow-up for acute bronchitis in younger patients but seems to have no effect in adults. However, reductions in future follow-up visits might be outweighed by increases in antibiotic consumption because patients who return for a follow-up visit seem to receive additional antibiotic prescriptions. Arch Fam Med. 2000;9:997-1001
authors: Department of Family Medicine, Medical University of South Carolina, 295 Calhoun St, PO Box 250192, Charleston, SC 29425. huestowj@musc.edu
authors: W J
authors: WJ
authors: Hueston
authors: R
authors: R
authors: Jenkins
authors: A G
authors: AG
authors: Mainous
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001991:Bronchitis / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002648:Child; D006801:Humans; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D001993:Bronchodilator Agents