TREATMENT OF ACUTE BRONCHITIS IN ADULTS - A NATIONAL SURVEY OF FAMILYPHYSICIANS

BACKGROUND. The purpose of this study was to determine how family phys icians in the United States treat acute bronchitis in an otherwise hea lthy adult. METHODS. A 33-item questionnaire on the diagnosis and trea tment of acute bronchitis was mailed to a random sample of 500 physici ans who are members of the American Board of Family Practice. RESULTS. Thirty-two of the 500 sampled physicians could not be located by mail ; 265 of those who received the questionnaire responded, The response rate was 57% (265/468), Sixty-three percent of responding physicians i ndicated that antibiotics are their first choice of treatment for the otherwise healthy, nonsmoking adult with acute bronchitis. The decisio n to use antibiotics as the first choice of treatment did not vary by physician's sex, age, years in practice, practice location, practice t ype, or percentage of HMO patients. Only 6% of responding physicians r eported using pp agonist bronchodilators as their first choice of trea tment, Physicians in this study stated that they prescribe an antibiot ic 75% of the time in treating nonsmoking patients with acute bronchit is (first choice or otherwise). If the patient is a smoker, physicians reported that they prescribe antibiotics 90% of the time (F=110.25; d f=1; P >.0001). Physicians reported that for patients who smoke it tak es longer for coughs to totally resolve and longer for them to return to a normal activity level than for nonsmokers. CONCLUSIONS. Family ph ysicians report that antibiotics are their most common treatment for a cute bronchitis in the otherwise healthy adult. Previous clinical tria ls have shown only marginal improvement in symptoms when patients with this condition are treated with an antibiotic. With antibiotic resist ance emerging as a major global health problem, it is essential that o ther methods of treatment be evaluated.