title: Principles of appropriate antibiotic use for treatment of uncomplicated acute bronchitis: background.
abstract: The following principles of appropriate antibiotic use for adults with acute bronchitis apply to immunocompetent adults without complicating comorbid conditions, such as chronic lung or heart disease. The evaluation of adults with an acute cough illness or a presumptive diagnosis of uncomplicated acute bronchitis should focus on ruling out serious illness, particularly pneumonia. In healthy, nonelderly adults, pneumonia is uncommon in the absence of vital sign abnormalities or asymmetrical lung sounds, and chest radiography is usually not indicated. In patients with cough lasting 3 weeks or longer, chest radiography may be warranted in the absence of other known causes. Routine antibiotic treatment of uncomplicated acute bronchitis is not recommended, regardless of duration of cough. If pertussis infection is suspected (an unusual circumstance), a diagnostic test should be performed and antimicrobial therapy initiated. Patient satisfaction with care for acute bronchitis depends most on physician--patient communication rather than on antibiotic treatment.
authors.affiliation: Division of General Internal Medicine, University of Colorado Health Sciences Center, Denver, 80262, USA.
authors.forename: R
authors.initials: R
authors.lastname: Gonzales
authors.forename: J G
authors.initials: JG
authors.lastname: Bartlett
authors.forename: R E
authors.initials: RE
authors.lastname: Besser
authors.forename: R J
authors.initials: RJ
authors.lastname: Cooper
authors.forename: J M
authors.initials: JM
authors.lastname: Hickner
authors.forename: J R
authors.initials: JR
authors.lastname: Hoffman
authors.forename: M A
authors.initials: MA
authors.lastname: Sande
mesh_terms: D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001991:Bronchitis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology / Q000523:psychology; D003142:Communication; D015897:Comorbidity; D006801:Humans; D007121:Immunocompetence; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D018579:Patient Selection; D010817:Physician-Patient Relations; D013997:Time Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents