Nicotra M B, Rivera M, Awe R J
Ann Intern Med. 1982 Jul;97(1):18-21. doi: 10.7326/0003-4819-97-1-18.
We conducted a double-blind, randomized, placebo-controlled trial in 40 patients to evaluate the need for antibiotics in acute exacerbations of chronic bronchitis. All patients were sufficiently ill to require hospitalization although none needed ventilatory support; the presence of pneumonia was excluded. Treatment consisted of bronchodilators, corticosteroids, and either tetracycline, 500 mg, or placebo by mouth every 6 hours for 1 week. Arterial blood gases, spirometric tests, bacteriologic evaluation of sputum, and patient and physician evaluation of the severity of illness were assessed at the beginning and end of the study. All patients improved both symptomatically and by objective measures of lung function. At the end of the study period there were no differences between those patients receiving tetracycline and those receiving placebo. We conclude that antibiotic therapy is not needed in moderately ill patients with exacerbations of chronic bronchitis.
我们对40例患者进行了一项双盲、随机、安慰剂对照试验，以评估慢性支气管炎急性加重期使用抗生素的必要性。所有患者病情严重，均需住院治疗，尽管无人需要通气支持；排除了肺炎的存在。治疗包括使用支气管扩张剂、皮质类固醇，以及每6小时口服500毫克四环素或安慰剂，持续1周。在研究开始和结束时，评估动脉血气、肺功能测试、痰液细菌学评估以及患者和医生对疾病严重程度的评估。所有患者的症状均有改善，肺功能的客观指标也有所改善。在研究期末，接受四环素治疗的患者与接受安慰剂治疗的患者之间没有差异。我们得出结论，中度病情的慢性支气管炎急性加重患者不需要抗生素治疗。
