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Current Clinical Topics in Infectious... 2000
Review
Topics: Acute Disease; Adult; Anti-Bacterial Agents; Bacterial Infections; Bronchial Hyperreactivity; Bronchitis; Bronchodilator Agents; Diagnosis, Differential; Humans; Pneumonia; Virus Diseases
PubMed: 10943523
DOI: No ID Found -
BMC Primary Care Apr 2023Acute bronchitis is one of the most frequent diagnoses in primary care. Scientifically, it is conceptualized as a viral infection. Still, general practitioners (GPs)...
BACKGROUND
Acute bronchitis is one of the most frequent diagnoses in primary care. Scientifically, it is conceptualized as a viral infection. Still, general practitioners (GPs) often prescribe antibiotics for acute bronchitis. The explanation for this discrepancy may lie in a different conceptualization of acute bronchitis. Therefore, we wanted to know, how GPs conceptualize acute bronchitis, and how they differentiate it from common cold and pneumonia. Furthermore, we tried to find out the GPs' reasons for prescribing antibiotics in those cases.
METHODS
To answer our study questions, we conducted a qualitative study with GPs in Bavaria, Germany, by using semi-structured guided interviews. The analysis of the data was conducted using the documentary method according to Ralf Bohnsack. The transcripts were subdivided into categories. Analyzing each part by reflective interpretation, first manually, secondly with the help of RQDA, we extracted the most representative citations and main messages from the interviews.
RESULTS
The term acute bronchitis seems to be applied when there is neither certainty of the diagnosis common cold, nor of pneumonia. It seems it bridges the gap of uncertainty between supposedly harmless clinical pictures (common cold/viral), to the more serious ones (pneumonia/bacterial). The conceptual transitions between common cold and acute bronchitis on the one side, and acute bronchitis and pneumonia on the other are fluid. The diagnosis acute bronchitis cannot solve the problem of uncertainty but seems to be a label to overcome it by offering a way to include different factors such as severity of symptoms, presumed signs of bacterial secondary infection, comorbidities, and presumed expectations of patients. It seems to solve the pathophysiologic riddle of bacterial or viral and of decision making in prescribing antibiotics.
CONCLUSION
Acute bronchitis as an "intermediate category" proved difficult to define for the GPs. Applying this diagnosis leaves GPs in abeyance of prescribing an antibiotic or not. As a consequence of this uncertainty in pathophysiologic reasoning (viral or bacterial) other clinical and social factors tip the balance towards antibiotic prescribing. Teaching physicians to better think in probabilities of outcomes instead of pathophysiologic reasoning and to deal with uncertainty might help reducing antibiotic overprescribing.
Topics: Humans; Respiratory Tract Infections; Common Cold; Concept Formation; Bronchitis; General Practice; Pneumonia; Anti-Bacterial Agents; Primary Health Care
PubMed: 37024785
DOI: 10.1186/s12875-023-02039-z -
Indian Pediatrics Dec 2004Plastic bronchitis is a rare disorder characterized by the formation of bronchial cast. The etiology is obscure, though usually associated with conditions like asthma,...
Plastic bronchitis is a rare disorder characterized by the formation of bronchial cast. The etiology is obscure, though usually associated with conditions like asthma, aspergillosis, pneumonia, cystic fibrosis and cardiac problems.
Topics: Acute Disease; Bronchitis; Bronchoscopy; Fatal Outcome; Female; Humans; Infant; Klebsiella Infections
PubMed: 15623909
DOI: No ID Found -
Chest May 2000Infectious agents are a major cause of acute exacerbations of chronic bronchitis (AECB) and COPD. Several respiratory viruses are associated with 30% of exacerbations,... (Review)
Review
Infectious agents are a major cause of acute exacerbations of chronic bronchitis (AECB) and COPD. Several respiratory viruses are associated with 30% of exacerbations, with or without a superimposed bacterial infection. Atypical bacteria, mostly Chlamydia pneumoniae, have been implicated in < 10% of AECB. The role of bacterial pathogens when isolated from the respiratory tract during AECB has become better defined by application of several newer investigative techniques. Bacterial pathogens can be isolated in significant concentrations from distal airways in 50% of AECB. Specific immune responses to surface exposed antigens of the infecting pathogen have been shown to develop after an exacerbation. Emerging evidence from molecular epidemiology and measurement of airway inflammation further support the role of bacteria in AECB. When properly defined, 80% of AECB are likely to be infectious in origin.
Topics: Acute Disease; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacteria; Bacterial Infections; Bronchi; Bronchitis; Bronchoalveolar Lavage Fluid; Bronchoscopy; Chronic Disease; Diagnosis, Differential; Drug Therapy, Combination; Humans; Secondary Prevention; Virulence
PubMed: 10843981
DOI: 10.1378/chest.117.5_suppl_2.380s -
Hospital Practice (Office Ed.) Aug 1991
Topics: Acute Disease; Bacterial Infections; Bronchitis; Humans
PubMed: 1869605
DOI: 10.1080/21548331.1991.11705273 -
Ryoikibetsu Shokogun Shirizu 1999
Review
Topics: Acute Disease; Animals; Anti-Bacterial Agents; Bronchitis; Expectorants; Humans; Lactams; Macrolides; Mucociliary Clearance; Respiratory Hypersensitivity
PubMed: 10088432
DOI: No ID Found -
Seminars in Respiratory Infections Mar 2000Pharmacoeconomic analysis involves the measurement of a ratio determining the extra costs required to achieve an additional unit of clinical benefit. Various techniques... (Review)
Review
Pharmacoeconomic analysis involves the measurement of a ratio determining the extra costs required to achieve an additional unit of clinical benefit. Various techniques including modeling studies, retrospective analysis of databases, "piggy-back" economic analysis of prospective randomized clinical trials, and prospective randomized pharmacoeconomic trials have been developed to aid in economic and health decisions. In acute exacerbations of chronic obstructive pulmonary disease, it is possible to identify a group of patients that are at high risk of treatment failure from routine antimicrobial therapy, hospitalization, respiratory failure, and death. The cost of therapy for this relatively small group of patients is extraordinarily high. Data from a variety of approaches have suggested that aggressive antimicrobial therapy may lead to improved outcomes in these patients. The corollary is that aggressive therapy directed toward patients with either acute bronchitis (mainly a viral infection) or exacerbations of trivial chronic obstructive lung disease leads to emergence of resistance and increased costs.
Topics: Acute Disease; Anti-Bacterial Agents; Bronchitis; Chronic Disease; Cost-Benefit Analysis; Costs and Cost Analysis; Decision Support Techniques; Humans; Randomized Controlled Trials as Topic; Respiratory Tract Infections; Risk; Smoking Cessation; Treatment Failure
PubMed: 10749552
DOI: 10.1053/srin.2000.0150071 -
American Family Physician May 2002Acute bronchitis is one of the top 10 conditions for which patients seek medical care. Physicians show considerable variability in describing the signs and symptoms... (Review)
Review
Acute bronchitis is one of the top 10 conditions for which patients seek medical care. Physicians show considerable variability in describing the signs and symptoms necessary to its diagnosis. Because acute bronchitis most often has a viral cause, symptomatic treatment with protussives, antitussives, or bronchodilators is appropriate. However, studies indicate that many physicians treat bronchitis with antibiotics. These drugs have generally been shown to be ineffective in patients with uncomplicated acute bronchitis. Furthermore, antibiotics often have detrimental side effects, and their overuse contributes to the increasing problem of antibiotic resistance. Patient satisfaction with the treatment of acute bronchitis is related to the quality of the physician-patient interaction rather than to prescription of an antibiotic.
Topics: Acute Disease; Anti-Bacterial Agents; Antitussive Agents; Bronchitis; Bronchodilator Agents; Expectorants; Humans
PubMed: 12046770
DOI: No ID Found -
Chest Dec 1997
Review
Topics: Acute Disease; Age Factors; Bacterial Infections; Bronchitis; Chronic Disease; Cough; Dyspnea; Forced Expiratory Volume; Humans; Lung Diseases, Obstructive; Practice Guidelines as Topic; Risk Factors; Sputum
PubMed: 9400894
DOI: 10.1378/chest.112.6_supplement.310s -
Duodecim; Laaketieteellinen... 2004
Topics: Acute Disease; Anti-Bacterial Agents; Bronchitis; Female; Finland; Humans; Incidence; Male; Prognosis; Risk Assessment; Severity of Illness Index; Treatment Outcome
PubMed: 15551767
DOI: No ID Found