Background: This #DoesItWorkSummary is based on the findings of a Cochrane Systematic Review published in June 2017 [1]. Acute bronchitis is condition associated with an acute cough, usually lasting for more than a week, which can be caused by viruses or bacteria. Antibiotics are commonly prescribed to treat acute bronchitis, but in the clinical practice usually there is no tests done to distinguish between bacterial bronchitis that might be influenced by antibiotics and viral bronchitis that would not be susceptible to antibiotics treatment. In this line, the benefits of antibiotic therapy of acute bronchitis remains questionable, and their use might have negative sides such as side effects, cost of treatment, and contribution to the development of antibiotic-resistant microbes. Antibiotic resistance, the development of which is promoted by excessive use of antibiotics, resulted in as many as 700 000 deaths per year already in 2016, and without significant contra-measures it is expected to reach 10 million deaths per year in the following 35 years [2]. A systematic evaluation of the existing human trial data was performed to get overview for the efficacy and side effects of antibiotics applied for treatment of acute bronchitis.
Findings: Analyzed were 17 trials involving 5099 people [1]. There was no statistical difference in the number of people who recovered with or without antibiotics. However the application of antibiotics resulted in small improvement of some of the parameters associated with the disease, such as cough (one out of six treated patients experienced less cough), and the total duration of experiencing the disease symptoms was shorter with around half a day (over an overall duration of 8‐ to 10‐days). One in 24 people taking antibiotics experienced side effects, most common of which were nausea, vomiting, diarrhoea, headache, and rash. Considering the side effects, the cost of treatment, and the contribution to the spread of antibiotic resistance, there is a very small resulting benefit to justify the application of antibiotics for acute bronchitis in people with a generally good health condition. More research is needed to address potential additional benefits from using antibiotics for acute bronchitis in frail, elderly people with multiple chronic conditions.
References
1 Smith, S.M., Fahey, T., Smucny, J. and Becker, L.A. (2017) Antibiotics for Acute Bronchitis. Cochrane Database of Systematic Reviews, John Wiley & Sons, Ltd. https://doi.org/10.1002/14651858.CD000245.pub4.
2 (2016) United Nations Meeting on Antimicrobial Resistance. Bulletin of the World Health Organization, World Health Organization, 94, 638–639. https://doi.org/10.2471/BLT.16.020916.
Keywords: #DoesItWorkSummary, antibiotics for acute bronchitis, side effects, cough, antibiotic therapy.
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