University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania.
J Emerg Med. 2022 Jul;63(1):10-16. doi: 10.1016/j.jemermed.2022.01.020. Epub 2022 Aug 3.
Antibiotics are not recommended in healthy, uncomplicated adults for the treatment of acute bronchitis, yet are still often prescribed. No randomized studies have examined whether prescribing antibiotics in the emergency department (ED) impacts hospital return rates.
Our aim was to compare hospital return rates between those who were prescribed an antibiotic vs. those who were not prescribed an antibiotic for the treatment of acute bronchitis.
A retrospective cohort study was completed evaluating patients aged 18-64 years who presented to a community teaching hospital ED with acute bronchitis between January 2017 and December 2019. The primary outcomes were 30-day ED return and hospital admissions from initial ED visit. The rates of ED return or readmitted were compared for patients prescribed an antibiotic for treatment of acute bronchitis vs. those patients who were not prescribed an antibiotic.
Of the 752 patients included, 311 (41%) were prescribed antibiotics. Baseline demographics were similar between both groups. Of those prescribed an antibiotic, 26 of 311 (8.4%) returned to the hospital within 30 days compared with 33 of 441 patients (7.5%) who were not prescribed an antibiotic (odds ratio 1.13; 95% confidence interval 0.66-1.92).
There was no association found between antibiotic therapy for treatment of acute bronchitis and return to the hospital.
抗生素不推荐用于治疗健康、无并发症的成人急性支气管炎，但仍经常被开具。没有随机研究检验过在急诊科开具抗生素是否会影响住院返院率。
我们旨在比较开具抗生素与不开具抗生素治疗急性支气管炎的患者之间的住院返院率。
回顾性队列研究评估了 2017 年 1 月至 2019 年 12 月期间因急性支气管炎到社区教学医院急诊科就诊的 18-64 岁患者。主要结局为 30 天内急诊科返院和初始急诊科就诊后的住院。比较了开具抗生素治疗急性支气管炎的患者与未开具抗生素的患者的急诊科返院或再入院率。
在纳入的 752 例患者中，311 例（41%）开具了抗生素。两组患者的基线人口统计学特征相似。在开具抗生素的患者中，311 例中有 26 例（8.4%）在 30 天内再次住院，而 441 例中未开具抗生素的患者有 33 例（7.5%）（比值比 1.13；95%置信区间 0.66-1.92）。
治疗急性支气管炎时使用抗生素与再次住院之间无关联。
