Does drug treatment of patients with acute bronchitis reduce additional care seeking? Evidence from the Practice Partner Research Network

Background: Considerable discussion has focused on treatment methods for pa tients with acute bronchitis. Objective: To examine whether antibiotic or bronchodilator treatment is ass ociated with differences in follow-up visit rates for patients with acute b ronchitis. Methods: A retrospective medical chart review was conducted for patients wi th a new episode of acute bronchitis over a 3-year period in the Practice F armer Research Network (29248 episodes in 24753 patients). Primary outcomes of interest were another visit in the next 14 days (early follow-up) or 15 to 28 days after initial treatment (late follow-up). Results: Antibiotics were used more commonly in younger patients (< 18 year s), whereas older patients (> 65 years) were more likely to receive no trea tment. Younger patients treated with antibiotics were less likely to return for an early follow-up visit, but no differences were seen in adults and o lder patients. Late follow-up rates were not affected by the initial treatm ent strategy. When patients did return for a follow-up visit, no new medica tion was prescribed to most (66% of younger patients and 78% of older adult s). However, compared with patients who did not receive an antibiotic at th eir first visit, patients initially treated with an antibiotic were about 5 0% more likely to receive a new antibiotic at their second visit. Conclusions: Initial prescribing of an antibiotic reduces early follow-up f or acute bronchitis in younger patients but seems to have no effect in adul ts. However, reductions in future follow-up visits might be outweighed by i ncreases in antibiotic consumption because patients who return for a follow -up visit seem to receive additional antibiotic prescriptions.