In cardiology, I can't complete the order form for a test if it is not supported by the listed diagnosis. We will have to do the same thing with antibiotics before the situation will ever change.
Antibiotic Prescriptions Continue for Bronchitis at High Rate — Physician’s First Watch
Antibiotic Prescriptions Continue for Bronchitis at High Rate
By Joe Elia
In acute bronchitis, the antibiotic prescription rate should be zero, yet despite years of federal efforts the rate hovers around 70%, a research letter in JAMA reports.
The letter writers used a nationally representative sample from U.S. ambulatory care databases for the period of 1996 to 2010. They assessed some 3200 new-problem visits by adults to primary care physicians or emergency departments for acute bronchitis. Overall, the rate of antibiotic prescription in the sample was 71%.
Factors such as type of insurance or region of the country did not have a measurable effect on the outcome: No group got within shouting (or coughing) distance of the national goal.
Reader Comments (4)
The question is when and under what circumstances antibiotics for acute bronchitis should be prescribed. The notion that antibiotics are never indicated is simply incorrect.
Eventually the inevitable conclusion will have to be reached that physicians are just not that bright.
As a family doc I firmly believe every case of acute bronchitis in any smoker should be treated with antibiotics. I have not seen any evidenced based studies for or against this strategy. Coding of co-morbidities is often lost in these prescribing surveys.