0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Position Papers |

Principles of Appropriate Antibiotic Use for Treatment of Uncomplicated Acute Bronchitis: Background

Ralph Gonzales, MD, MSPH; John G. Bartlett, MD; Richard E. Besser, MD; Richelle J. Cooper, MD, MSHS; John M. Hickner, MD, MSc; Jerome R. Hoffman, MD, MA; and Merle A. Sande, MD
[+] Article and Author Information

From the University of Colorado Health Sciences Center, Denver, Colorado; Johns Hopkins University, Baltimore, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia; University of California, Los Angeles, Los Angeles, California; Michigan State University, East Lansing, Michigan; and University of Utah, Salt Lake City, Utah.


*After the primary author (Dr. Gonzales), authors are listed in alphabetical order.

In addition to the Centers for Disease Control and Prevention, the principles outlined in this document have been endorsed by the American Academy of Family Physicians, the American College of Physicians–American Society of Internal Medicine, and the Infectious Diseases Society of America.

Annals of Internal Medicine encourages readers to copy and distribute this paper, providing such distribution is not for profit. Commercial distribution is not permitted without the express permission of the publisher.

Acknowledgments: External review has included feedback from the Centers for Disease Control and Prevention; the American College of Physicians–American Society of Internal Medicine Clinical Efficacy Assessment Subcommittee; and representatives of the American Academy of Family Physicians, the American College of Emergency Physicians, and the Infectious Diseases Society of America.

Role of the Funding Sources: Partial support for the development of the Principles was provided by the Centers for Disease Control and Prevention, and final approval by the Centers for Disease Control and Prevention of all manuscripts submitted for publication was required. Dr. Cooper is supported by a National Research Service Award (F32 HS00134-1) from the Agency for Healthcare Research and Quality.

Requests for Single Reprints: Richard E. Besser, MD, Respiratory Diseases Branch (C-23), Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333; e-mail, rbesser@cdc.gov.

Current Author Addresses: Dr. Gonzales: Division of General Internal Medicine, Campus Box B-180, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Denver, CO 80262.

Dr. Bartlett: Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 463A, Baltimore, MD 21287-0003.

Dr. Besser: Respiratory Diseases Branch (C-23), Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333.

Drs. Cooper and Hoffman: UCLA Emergency Medicine Center, 924 Westwood Boulevard, Suite 300, Los Angeles, CA 90024.

Dr. Hickner: Department of Family Practice, Michigan State University, B-111 Clinical Center, East Lansing, MI 48824.

Dr. Sande: Department of Medicine (4C104), University of Utah, 50 North Medical Drive, Salt Lake City, UT 84132.


Ann Intern Med. 2001;134(6):521-529. doi:10.7326/0003-4819-134-6-200103200-00021
Text Size: A A A

The following principles of appropriate antibiotic use for adults with acute bronchitis apply to immunocompetent adults without complicating comorbid conditions, such as chronic lung or heart disease.

1. The evaluation of adults with an acute cough illness or a presumptive diagnosis of uncomplicated acute bronchitis should focus on ruling out serious illness, particularly pneumonia. In healthy, nonelderly adults, pneumonia is uncommon in the absence of vital sign abnormalities or asymmetrical lung sounds, and chest radiography is usually not indicated. In patients with cough lasting 3 weeks or longer, chest radiography may be warranted in the absence of other known causes.

2. Routine antibiotic treatment of uncomplicated acute bronchitis is not recommended, regardless of duration of cough. If pertussis infection is suspected (an unusual circumstance), a diagnostic test should be performed and antimicrobial therapy initiated.

3. Patient satisfaction with care for acute bronchitis depends most on physician–patient communication rather than on antibiotic treatment.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)