Two doctors at Brigham and Women’s Hospital in Boston recently discovered that the prescription rate for acute bronchitis treatment between 1992 – 2010 was 71%, a troubling finding considering the rate should actually be 0%. Michael L. Barnett, MD, and Jeffrey A. Linder, MD, collected data for 3,151 patients sampled from the annual National Medical Care Survey and National Hospital Ambulatory Medical Care Survey. There findings were published in the JAMA Network Journals.
Not only was the prescription rate high, but also it increased over time. In one specific example, physicians prescribed extended macrolides for 25% of acute bronchitis visits in 1996-1998 and 41% in 2008-2010.
“It’s a medicine that’s not going to help and somewhere between five and 25 percent of people will have side effects,” commented Dr. Linder in a news story. “Continuing education, giving patients the knowledge, and letting them know there is nothing we can do to help it get better faster” are the best recommendations Dr. Linder can give.
The Center for Disease Control and Prevention specifically states that acute bronchitis almost always results from a virus and therefore should not be treated with antibiotics. Doing so could lead to antibiotic resistance, making the treatment of respiratory infections such as pneumonia and whopping cough more difficult. Although many doctors prescribe antibiotics to relieve symptoms, acute bronchitis often clears on its own within days, and symptoms subside after two weeks. It is best treated through prevention. But according the Dr. Linder, “Sometimes a patient will take a half a day off to come into the clinic and it’s unsatisfying to tell someone you have this cough and it’ll go away.”
“We were hopeful that the CDC and health plans would discourage people from prescribing antibiotics when it wasn’t necessary,” said Dr. Linder. “Currently the correct rate of prescribing is zero.”
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