antibiotics for acute bronchitis

9 Nov

stolen from June’s EP Monthly, full article here


acute bronchitis defined as:

  • cough-related illness
  • with/without sputum
  • patient without chronic lung disease
  • normal chest X-ray


<10% of cases thought to be bacterial


antibiotics are prescribed for 60-80% outpatient cases


15 RCTs covered in a review

  • antibiotics did NOT increase # of patients who were “cured” (clinically improved) at follow-up
  • did decrease # of patients with cough at follow-up (NNT=6)
  • 1/2-day reduction in duration of cough/feeling ill/limited ADLs
  • no serious complications of bronchitis in either (abx or no abx) group


adverse effects (NNH=37)

  • yeast infections
  • rash
  • diarrhea
  • allergic reactions
  • c-diff


References: EP monthly article; picture


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