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	Institution: STANFORD Univ Med Center  | My Account | E-mail Alerts | Access Rights | Sign In Vol. 5 No. 2, February 1996   Archives  •  Online Features ORIGINAL CONTRIBUTION  This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal Current Management of Acute Bronchitis in Ambulatory Care The Use of Antibiotics and Bronchodilators Arch G. Mainous III, PhD; Roger J. Zoorob, MD; William J. Hueston, MD Arch Fam Med. 1996;5(2):79-83. Abstract Objective To examine the treatment regimens for acute bronchitis in adults in a Medicaid population seen in ambulatoryttings. Design Cross-sectional sample of Kentucky Medicaid claims (July 1, 1993, through June 30, 1994). Participants Individuals 18 years old or older seen in an ambulatory setting for acute bronchitis. Anyone with a primary diagnosis of asthma or chronic obstructivemonary disease within the time frame was excluded. Twelve hundred ninety-fours accounted for 1635 separate outpatient and emergency department encounters for acute bronchitis. Outpatient visits accounted for 89% (n=1448) encounters. Results In 22% (n=358) encounters, no medication was prescribed; in 61% (n=997), antibiotics alone were prescribed, in 3% (n=43), odilators alone were prescribed; and in 14% (n=237antibiotics and bronchodilators were prescribed. Some type of medication was more likely to be prescibed emergency departments than in outpatient settings (P=.04), and antibiotic/bronchodilator combination therapy was more likely to be prescribed in rural practices than in urban practices (P<.001). Broadspectrum antibiotics were more likely than narrowspectrum antibiotics to be used in combination with a bronchodilator (P=.001). Penicillins were the most widely used antibiotics (37%), but broad-spectrum agents, such as second- and third-generation cephalosporins (10%) and fluoroquinolones (5%), were also prescribed. Conclusions Although evidence suggests that antibiotic treatment is not usually indicated for treatment of acute bronchitis, these results indicate that antibiotics are still the predominant treatment regimen in ambulatory care. Furthermore, the evidence suggesting that bronchodilators are effective symptomatic treatments has not been widely adopted. These results have significant implications for the production of antibiotic-resistant bacteria and suggest investigation into why physicians have not used this information in their treatment of acute bronchitis. Author Affiliations From the Department of Family Practice (Drs Mainous and Zoorob), University of Kentucky, Lexington; and the Eau Claire Family Practice Residency, Department of Family Medicine, University of Wisconsin—Madison (Dr Hueston). THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES One hundred coughs: Family practice case series Worrall cfp 2008;54:236-237. ABSTRACT | FULL TEXT   Trends in Antimicrobial Prescribing for Bronchitis and Upper Respiratory Infections Among Adults and Children Mainous et al. AJPH 2003;93:1910-1914. ABSTRACT | FULL TEXT   Antibiotics for Common Respiratory Tract Infections in Adults Hirschmann Arch Intern Med 2002;162:256-264. ABSTRACT | FULL TEXT   Management of adult lower respiratory tract infection in primary care STEELE et al. Thorax 2001;56:87-88. FULL TEXT   Does Drug Treatment of Patients With Acute Bronchitis Reduce Additional Care Seeking?: Evidence From the Practice Partner Research Network Hueston et al. Arch Fam Med 2000;9:997-1001. ABSTRACT | FULL TEXT   Antibiotics for Upper Respiratory Tract Infections: Follow-up Utilization and Antibiotic Use Hueston et al. Arch Fam Med 1999;8:426-430. ABSTRACT | FULL TEXT   National Trends in the Use of Antibiotics by Primary Care Physicians for Adult Patients With Cough Metlay et al. Arch Intern Med 1998;158:1813-1818. ABSTRACT | FULL TEXT   Antibiotics for Colds in Children: Who Are the High Prescribers? Mainous III et al. Arch Pediatr Adolesc Med 1998;152:349-352. ABSTRACT | FULL TEXT   Antibiotic Prescribing for Adults With Colds, Upper Respiratory Tract Infections, and Bronchitis by Ambulatory Care Physicians Gonzales et al. JAMA 1997;278:901-904. ABSTRACT   Current Management of Acute Bronchitis in Ambulatory Care Benz Arch Fam Med 1996;5:440-440. ABSTRACT   Current Management of Acute Bronchitis in Ambulatory Care Hahn Arch Fam Med 1996;5:439-439. ABSTRACT   Treatment of Acute Bronchitis: There's Much Work to Be Done Williamson Arch Fam Med 1996;5:84-85. ABSTRACT   Bronchodilators and Antibiotics in the Treatment of Acute Bronchitis King Arch Fam Med 1996;5:86-86. ABSTRACT   HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | PHYSICIAN JOBS | HELP CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP   © 1996 American Medical Association. All Rights Reserved.