Current management of acute bronchitis in ambulatory care: The use of antibiotics and bronchodilators

作者：Arch G. Mainous · 发表于：Archives of Family Medicine · 年份：1996 · DOI：10.1001/archfami.5.2.79 · 被引用次数：57 · 研究领域：Antibiotic Use and Resistance、Pneumonia and Respiratory Infections、Respiratory viral infections research

OBJECTIVE: To examine the treatment regimens for acute bronchitis in adults in a Medicaid population seen in ambulatory care settings. DESIGN: Cross-sectional sample of Kentucky Medicaid claims (July 1, 1993, through June 30, 1994). PARTICIPANTS: Individuals 18 years old or older seen in an ambulatory setting for acute bronchitis. Anyone with a primary diagnosis of asthma or chronic obstructive pulmonary disease within the time frame was excluded. Twelve hundred ninety-four individuals accounted for 1635 separate outpatient and emergency department encounters for acute bronchitis. Outpatient visits accounted for 89% (n=1448) of the encounters. RESULTS: In 22% (n=358) of the encounters, no medication was prescribed; in 61% (n=997), antibiotics alone were prescribed, in 3% (n=43), bronchodilators alone were prescribed; and in 14% (n=237), both antibiotics and bronchodilators were prescribed. Some type of medication was more likely to be prescribed in emergency departments than in outpatient settings (P=.04), and antibiotic/bronchodilator combination therapy was more likely to be prescribed in rural practices than in urban practices (P<.001). Broad-spectrum were more likely than narrow-spectrum antibiotics to be used in combination with a bronchodilator (P=.001). Penicillins were the most widely used antibiotics (37%), but broad-spectrum agents, such as second- and third-generation cephalosporins (10%) and fluoroquinolones (5%), were also prescribed. CONCLUSIONS: Although eviden...