Doctors say antibiotics pointless for acute bronchitis

Nov 16 2006

Researchers say they have found no evidence in current literature that antibiotics are effective in treating the vast majority of patients with acute bronchitis and say doctors should stop routinely prescribing them.

Acute bronchitis is an inflammation of the main airways to the lungs characterised by an irritating cough, and is one of the most common conditions treated by doctors.

Acute bronchitis occurs in about 5 percent of adults each year and doctors prescribe antibiotics to 70 percent to 80 percent of patients for the condition.

But two doctors from Virginia Commonwealth University say in almost all cases the infections are viral infections and do not respond to antibiotics.

They also found little evidence that cough medicine, also prescribed in most acute bronchitis cases, had any value.

Dr. Richard Wenzel, chairman of the Department of Internal Medicine at VCU's School of Medicine, and colleague Dr. Alpha Fowler, say doctors should send patients home with acute bronchitis, empty handed, as only a few percent of acute bronchitis cases might have a bacterial cause necessitating antibiotics.

The two doctors examined research studies and clinical trials regarding acute bronchitis as they related to individuals, pathology, diagnosis, treatment strategies and any data supporting the potential benefits of anti-bacterial agents.

The doctors say most cases will go away on their own after a few days or a week, and recommend rest and drinking lots of fluids.

Wenzel, has voiced concern about the routine prescription of antibiotics in such cases, as apart from the fact they do not help most patients, the cost of pointless doses of the antibiotics runs into millions and they produce unwanted side effects such as diarrhea, gastric upset, rash, headaches and muscle aches.

Wenzel also says that taking unnecessary antibiotics adds to the problem of bacteria becoming resistant to them, thus rendering them less useful for treatment of infections.

Wenzel says he hopes that doctors will think twice and spend a few minutes explaining to patients why it is unnecessary to take an antibiotic in these cases.

The report is published in the New England Journal of Medicine.