Principles of appropriate antibiotic use for treatment of uncomplicated acute bronchitis: Background
Abstract
The term acute bronchitis usually designates an acute respiratory tract infection in which cough, with or without phlegm, is a predominant feature (1, 2). In the United States, about 5% of adults self-report an episode of acute bronchitis each year, and up to 90% of these persons seek medical attention (3-5). In 1997, adults in the United States made more than 10 million office visits for bronchitis (6). As a result, acute bronchitis consistently ranks among the 10 conditions that account for most ambulatory office visits to U.S. physicians (6-11). Most cases of acute bronchitis occur in otherwise healthy adults, in whom this acute cough illness can be called uncomplicated acute bronchitis; these principles are intended to apply to such patients. The evaluation and management of acute cough illness in patients with underlying chronic obstructive pulmonary disease, congestive heart failure, or immunosuppression must be tailored in light of the patient's comorbid condition and is outside the scope of this discussion. The background of, rationale for, and methods used to develop these principles are published separately (12). Principles 1.0 Evaluation of Acute Cough Illness Principle 1. The evaluation of adults with an acute cough illnessor a presumptive diagnosis of uncomplicated acute bronchitis should focus on ruling out serious illness, particularly pneumonia. 1.1 A wide variety of infections and inflammatory disorders can lead to an acute cough illness. The American…
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