Dunlay J, Reinhardt R
J Fam Pract. 1984 May;18(5):719-22.
Although several surveys rank acute bronchitis as one of the ten most frequent diagnoses made by primary care physicians, its clinical features are poorly defined and treatment with antibiotics is controversial. This study was designed to determine the clinical characteristics that providers use to diagnose acute bronchitis and to examine the use of antibiotics in treating this illness. Charts of patients with the diagnosis of acute bronchitis or upper respiratory tract infection (URI) were randomly selected and progress notes from these visits were reviewed. Signs, symptoms, laboratory tests, and antibiotics prescribed were recorded. Patients with a diagnosis of acute bronchitis had more productive cough, purulent sputum, and abnormal lung examinations than patients with a diagnosis of URI (P less than .05 for each characteristic). Laboratory tests, including chest roentgenograms, were not frequently used in making the diagnosis of acute bronchitis. Antibotics were prescribed for 27 of 29 patients (92 percent) with a diagnosis of acute bronchitis but for only 4 of 19 patients (21 percent) with a diagnosis of URI. Erythromycin was prescribed for 60 percent of patients with acute bronchitis. From this study it can be concluded that providers use the term acute bronchitis to designate a specific clinical syndrome that they treat with antibiotics. Further clinical trials are needed to evaluate the efficacy of such antibiotic therapy.
尽管多项调查将急性支气管炎列为初级保健医生最常做出的十大诊断之一，但其临床特征定义不明确，使用抗生素治疗也存在争议。本研究旨在确定医疗服务提供者用于诊断急性支气管炎的临床特征，并检查抗生素在治疗该疾病中的使用情况。随机选择诊断为急性支气管炎或上呼吸道感染（URI）的患者病历，并查阅这些就诊的病程记录。记录体征、症状、实验室检查和所开的抗生素。诊断为急性支气管炎的患者比诊断为URI的患者有更多的咳痰、脓性痰和肺部检查异常（每个特征P值均小于0.05）。包括胸部X光片在内的实验室检查在急性支气管炎诊断中并不常用。29例诊断为急性支气管炎的患者中有27例（92%）使用了抗生素，但19例诊断为URI的患者中只有4例（21%）使用了抗生素。60%诊断为急性支气管炎的患者使用了红霉素。从这项研究可以得出结论，医疗服务提供者使用“急性支气管炎”一词来指代他们用抗生素治疗的特定临床综合征。需要进一步的临床试验来评估这种抗生素治疗的疗效。
