title: Role of Atypical Pathogens and the Antibiotic Prescription Pattern in Acute Bronchitis: A Multicenter Study in Korea.
abstract: The role of atypical bacteria and the effect of antibiotic treatments in acute bronchitis are still not clear. This study was conducted at 22 hospitals (17 primary care clinics and 5 university hospitals) in Korea. Outpatients (aged ≥ 18 yr) who had an acute illness with a new cough and sputum (≤ 30 days) were enrolled in 2013. Multiplex real-time polymerase chain reaction (RT-PCR) was used to detect five atypical bacteria. A total of 435 patients were diagnosed as having acute bronchitis (vs. probable pneumonia, n = 75), and 1.8% (n = 8) were positive for atypical pathogens (Bordetella pertussis, n = 3; B. parapertussis, n = 0; Mycoplasma pneumoniae, n = 1; Chlamydophila pneumoniae, n = 3; Legionella pneumophila, n = 1). Among clinical symptoms and signs, only post-tussive vomiting was more frequent in patients with atypical pathogens than those without (P = 0.024). In all, 72.2% of the enrolled patients received antibiotic treatment at their first visits, and β-lactams (29.4%) and quinolones (20.5%) were the most commonly prescribed agents. In conclusion, our study demonstrates that the incidence of atypical pathogens is low in patients with acute bronchitis, and the rate of antibiotic prescriptions is high.
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Sunghoon
authors.initials: S
authors.lastname: Park
authors.affiliation: Myeongmun Clinic of Internal Medicine, Yongin, Korea.
authors.forename: Kil Chan
authors.initials: KC
authors.lastname: Oh
authors.affiliation: Joeun Clinic of Internal Medicine, Dangjin, Korea.
authors.forename: Ki-Seong
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Neulpurun Clinic of Otolaryngology, Anyang, Korea.
authors.forename: Kyu-Tae
authors.initials: KT
authors.lastname: Song
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Konkuk University Hospital, Seoul, Korea.
authors.forename: Kwang Ha
authors.initials: KH
authors.lastname: Yoo
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Yun Su
authors.initials: YS
authors.lastname: Shim
authors.affiliation: Pyeongchon-Family Clinic of Internal Medicine, Anyang, Korea.
authors.forename: Young Ju
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
authors.forename: Myung Goo
authors.initials: MG
authors.lastname: Lee
authors.affiliation: Haengbok-Dream Clinic of Internal Medicine, Daegu, Korea.
authors.forename: Jang Uk
authors.initials: JU
authors.lastname: Yun
authors.affiliation: Hanyang Clinic of Internal Medicine, Seoul, Korea.
authors.forename: Hyun Su
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Yee Hyung
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Hongjunggon Clinic of Internal Medicine, Anyang, Korea.
authors.forename: Won Jun
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: Rapha Clinic of Otolaryngology, Anyang, Korea.
authors.forename: Do Il
authors.initials: DI
authors.lastname: Kim
authors.affiliation: Chahyunggun Clinic of Otolaryngology, Anyang, Korea.
authors.forename: Hyung Gun
authors.initials: HG
authors.lastname: Cha
authors.affiliation: Leejaemyung Clinic of Internal Medicine, Anyang, Korea.
authors.forename: Jae-Myung
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Seojungsan Clinic of Internal Medicine, Seoul, Korea.
authors.forename: Jung San
authors.initials: JS
authors.lastname: Seo
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Ki-Suck
authors.initials: KS
authors.lastname: Jung
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D042483:Bordetella parapertussis / Q000235:genetics / Q000302:isolation & purification*; D001886:Bordetella pertussis / Q000235:genetics / Q000302:isolation & purification*; D001991:Bronchitis / Q000188:drug therapy / Q000382:microbiology*; D016993:Chlamydophila pneumoniae / Q000235:genetics / Q000302:isolation & purification*; D017714:Community-Acquired Infections / Q000382:microbiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D016952:Legionella pneumophila / Q000235:genetics / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D009177:Mycoplasma pneumoniae / Q000235:genetics / Q000302:isolation & purification*; D060888:Real-Time Polymerase Chain Reaction; D056910:Republic of Korea; D013183:Sputum / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acute Bronchitis; Antibiotics; Atypical Pathogens; Korea