DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20201311

A study of effect of medications on patients with non complicated acute bronchitis

Rohit S. Shukla, Anshuman Sharma

Abstract


Background: Authors define acute bronchitis as a self-limiting infection of large airways, which is characterized by cough without pneumonia. NSAIDS (Non-steroidal anti-inflammatory drugs) are prescribed in patients with Lower Respiratory Tract Infections (LRTI). In cough, fever and chest pain it is common practice to prescribe NSAIDS or antibiotics. Authors have conducted assessment of effect of medications in the resolution of cough of patients with uncomplicated acute bronchitis.

Methods: It was a single blinded randomized clinical trial conducted in patients admitted to pulmonary medicine department of government medical college Shivpuri. Patients were from age group 18 to 70 years presenting with respiratory tract infection of less than one week’s duration, with cough as the predominant symptom and diagnosed with non-complicated acute bronchitis. Patients were randomized into two groups, group A and B according to medications.

Results: Among 120 participants were randomized (60 to ibuprofen and 60 to antibiotic). The median number of days with frequent cough was slightly lower among patients of group A (12 days) compared with those receiving amoxicillin-clavulanic acid (14 days). No significant difference was found. Adverse effect was seen in 24 patients, which was most common in group B (15.25%) than group A (9.15%). p<0.05).

Conclusions: No significant differences were observed in the number of days with cough between patients with uncomplicated acute bronchitis treated with ibuprofen or amoxicillin-clavulanic acid.


Keywords


Acute bronchitis, Cough, Sputum, Lower respiratory tract infection, Medications

Full Text:

PDF

References


Macfarlane J, Holmes W, Gard P, Macfarlane R, Rose D, Weston V, et al. Prospective study of the incidence, aetiology and outcome of adult lower respiratory tract illness in the community. Thorax. 2001 Feb 1;56(2):109-14.

Woodhead M, Blasi F, Ewig S, Garau J, Huchon G, Ieven M, et al. Guidelines for the management of adult lower respiratory tract infections‐Full version. Clin Microbiol Infec. 2011 Nov;17:E1-59.

Ashworth M, Charlton J, Ballard K, Latinovic R, Gulliford M. Variations in antibiotic prescribing and consultation rates for acute respiratory infection in UK general practices 1995-2000. Br J Gen Pract. 2005 Aug 1;55(517):603-8.

Chalmers JD, Hill AT. Investigation of “non-responding” presumed lower respiratory tract infection in primary care. BMJ. 2011 Oct 13;343:d5840.

Boivin G, Abed Y, Pelletier G, Ruel L, Moisan D, Côté S, et al. Virological features and clinical manifestations associated with human metapneumovirus: a new paramyxovirus responsible for acute respiratory-tract infections in all age groups. J Infec Dis. 2002 Nov 1;186(9):1330-4.

Bastien N, Ward D, Van Caeseele P, Brandt K, Lee SH, McNabb G, et al. Human metapneumovirus infection in the Canadian population. J Clin Microbiol. 2003;41:4642-6.

Jindal SK, Aggarwal AN, Gupta D, Agarwal R, Kumar R, Kaur T, et al. Indian study on epidemiology of asthma, respiratory symptoms and chronic bronchitis in adults (INSEARCH). The Intern J Tuber Lung Dis. 2012 Sep 1;16(9):1270-7.

Butler CC, Hood K, Verheij T, Little P, Melbye H, Nuttall J, et al. Variation in antibiotic prescribing and its impact on recovery in patients with acute cough in primary care: prospective study in 13 countries. BMJ. 2009 Jun 24;338:b2242.

Goossens H, Ferech M, Vander Stichele R, Elseviers M, ESAC Project Group. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet. 2005 Feb 12;365(9459):579-87.

Smith SM, Schroeder K, Fahey T. Over-the-counter (OTC) medications for acute cough in children and adults in ambulatory settings. Coch Data Syst Rev. 2012;(4):CD001831.

Becker LA, Hom J, Villasis-Keever M, van der Wouden JC. Beta2-agonists for acute bronchitis. Cochrane Database Syst Rev. 2011;(7):CD001726.

Raherison C, Poirier R, Daurès JP, Romand P, Grignet JP, Arsac P, et al. Lower respiratory tract infections in adults: non-antibiotic prescriptions by GPs. Resp Med. 2003 Sep 1;97(9):995-1000.

Smith S, Fahey T, Smucny J, Becker L. Antibiotics for acute bronchitis. Cochrane Database Syst Rev. 2012;(4):CD000245.

Butler CC, Kelly MJ, Hood K, Schaberg T, Melbye H, Serra-Prat M, et al. Antibiotic prescribing for discoloured sputum in acute cough/lower respiratory tract infection. Eur Resp J. 2011 Jul 1;38(1):119-25.

Anthonisen NR, Manfreda J, Warren CPW, Hershfield ES, Harding GKM, Nelson NA. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med. 1987;106:196-204.

Llor C, Moragas A, Hernández S, Bayona C, Miravitlles M. Efficacy of antibiotic therapy for acute exacerbations of mild to moderate chronic obstructive pulmonary disease. Am J Resp Critical Care Med. 2012 Oct 15;186(8):716-23.

Macfarlane JT, Worboys M. The changing management of acute bronchitis in Britain, 1940-1970: the impact of antibiotics. Med History. 2008 Jan;52(1):47-72.

Bent S, Saint S, Vittinghoff E, Grady D. Antibiotics in acute bronchitis: a meta-analysis. Am J Med. 1999 Jul 1;107(1):62-7.

Little P, Stuart B, Moore M, Coenen S, Butler CC, Godycki-Cwirko M, et al. Amoxicillin for acute lower-respiratory-tract infection in primary care when pneumonia is not suspected: a 12-country, randomised, placebo-controlled trial. Lancet Infec Dis. 2013 Feb 1;13(2):123-9.

Stott NC, West RR. Randomised controlled trial of antibiotics in patients with cough and purulent sputum. Br Med J. 1976 Sep 4;2(6035):556-9.

Snow V, Mottur-Pilson C, Cooper RJ, Hoffman JR. Principles of appropriate antibiotic use for acute pharyngitis in adults. Annal Inter Med. 2001 Mar 20;134(6):506-8.

Linder JA. Editorial commentary: antibiotics for treatment of acute respiratory tract infections: decreasing benefit, increasing risk, and the irrelevance of antimicrobial resistance. Clin Infect Dis. 2008;47:744-6.

Gonzales R, Malone DC, Maselli JH, Sande MA. Excessive antibiotic use for acute respiratory infections in the United States. Clin Infec Dis. 2001 Sep 15;33(6):757-62.

Mainous 3rd AG, Zoorob RJ, Hueston WJ. Current management of acute bronchitis in ambulatory care: the use of antibiotics and bronchodilators. Archiv Family Med. 1996 Feb;5(2):79.

Gonzales R, Steiner JF, Sande MA. Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians. JAMA. 1997 Sep 17;278(11):901-4.

Carl Llor, Ana Moragas, Carolina Bayona, Rosa Morros, Helena Pera, Oleguer Plana-Ripol. Efficacy of anti-inflammatory or antibiotic treatment in patients with non-complicated acute bronchitis and discoloured sputum: randomized placebo controlled trial. BMJ. 2013;347:57-69.