One of the main problems of our century is the rapid development of such a dangerous phenomenon as antibiotic resistance.
Main causes of antibiotic resistance – unreasonable prescription of antibiotics, low patient adherence to treatment, premature interruption of antibiotic therapy.
Acute bronchitis – a pathological condition caused, in most cases, by viral agents. Unfortunately, the appointment of "empirical" antibiotic therapy for acute bronchitis is not uncommon.
Read about the modern principles of treatment of acute bronchitis, which meet international recommendations and postulates of evidence-based medicine, on estet-portal.com in this article.
Etiological causes and clinical symptoms of acute bronchitis
In most cases, acute bronchitis has a viral etiology.
The most common infectious agents that cause acute bronchitis are coronaviruses, respiratory syncytial (RS) viruses, adenoviruses, parainfluenza and influenza viruses.
The following key symptoms of acute bronchitis should be highlighted:
1. Cough with sputum production;
2. Shortness of breath;
3. Wheezing;
4. Chest pain;
5. Fever: temperature may exceed 38 degrees (observed in 10-30% of patients with acute bronchitis).
Principles for the diagnosis and treatment of mycoplasma respiratory tract infections
Acute bronchitis is usually associated with an upper respiratory tract infection, so patients often present with rhinitis, sore throat, and hoarseness at the same time.
Principles for the diagnosis of acute bronchitis: international guidelines
Diagnosis of acute bronchitis is based on a clinical history, clinical examination and follow-up of the patient.
Microbiological examination of sputum in acute bronchitis, according to international recommendations, is not appropriate.
The physician must determine whether a patient with acute bronchitis is at high risk of developing pneumonia, which will be discussed in more detail below.
The chance of developing pneumonia in patients with a heart rate of less than 100 beats per minute, a respiratory rate of less than 20 per minute, and a body temperature of less than 38 degrees is very low (according to the EBM Guidelines «Acute bronchitis»).
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Treatment of acute bronchitis: when antibiotic therapy is really indicated
It is interesting that such "folk" remedies like warm tea, honey and eucalyptus oil are recommended by international protocols for the treatment of acute bronchitis. Their use helps to moisten the mucous membrane of the pharynx and larynx, thereby relieving such a symptom as coughing.
In most cases, acute bronchitis has a viral etiology, so empiric antibiotics are not appropriate.
Empirical antimicrobial therapy is indicated only for patients who are prone to developing pneumonia due to their health.
This group of patients includes:
1. Persons over the age of 75 with a high fever;
2. Patients with concomitant chronic severe diseases, heart failure, COPD;
3. Patients who take insulin;
4. Persons suffering from alcoholism.
If the above conditions occur in a patient with acute bronchitis, empiric antibiotic therapy should be prescribed, which is discussed in more detail later in the article.
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Antibiotic therapy: dosing regimens for acute bronchitis
The antibiotic of choice is amoxicillin 750 mg three times a day. In case of allergy to penicillins, doxycycline 150 mg once a day should be given.
The average duration of antibiotic therapy is 5-7 days.
No broad-spectrum antimicrobials should be used in the treatment of acute bronchitis without specific justification.
If the doctor suspects a mycoplasmal or chlamydial etiology of the disease, then doxycycline is the antibiotic of choice.
Thank you for staying with estet-portal.com Read other interesting articles in the "Infectology" section. You may also be interested in: Influenza season is coming: modern approaches to treatment and prevention
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