Oeffinger K C, Snell L M, Foster B M, Panico K G, Archer R K
Department of Family Practice and Community Medicine, University of Texas Southwestern Medical Center at Dallas 75235-9067, USA.
J Fam Pract. 1998 Jun;46(6):469-75.
The purpose of this study was to determine how family physicians in the United States treat acute bronchitis in an otherwise healthy adult.
A 33-item questionnaire on the diagnosis and treatment of acute bronchitis was mailed to a random sample of 500 physicians who are members of the American Board of Family Practice.
Thirty-two of the 500 sampled physicians could not be located by mail; 265 of those who received the questionnaire responded. The response rate was 57% (265/468). Sixty-three percent of responding physicians indicated that antibiotics are their first choice of treatment for the otherwise healthy, nonsmoking adult with acute bronchitis. The decision to use antibiotics as the first choice of treatment did not vary by physician's sex, age, years in practice, practice location, practice type, or percentage of HMO patients. Only 6% of responding physicians reported using beta 2 agonist bronchodilators as their first choice of treatment. Physicians in this study stated that they prescribe an antibiotic 75% of the time in treating nonsmoking patients with acute bronchitis (first choice or otherwise). If the patient is a smoker, physicians reported that they prescribe antibiotics 90% of the time (F = 110.25; df = 1; P > .0001). Physicians reported that for patients who smoke it takes longer for coughs to totally resolve and longer for them to return to a normal activity level than for nonsmokers.
Family physicians report that antibiotics are their most common treatment for acute bronchitis in the otherwise healthy adult. Previous clinical trials have shown only marginal improvement in symptoms when patients with this condition are treated with an antibiotic. With antibiotic resistance emerging as a major global health problem, it is essential that other methods of treatment be evaluated.
本研究的目的是确定美国的家庭医生如何治疗健康状况良好的成年急性支气管炎患者。
一份关于急性支气管炎诊断和治疗的33项问卷被邮寄给美国家庭医疗委员会的500名医生组成的随机样本。
500名抽样医生中有32名无法通过邮件联系到；收到问卷的医生中有265名回复。回复率为57%（265/468）。63%的回复医生表示，对于健康状况良好、不吸烟的成年急性支气管炎患者，抗生素是他们的首选治疗方法。将抗生素作为首选治疗方法的决定不因医生的性别、年龄、从业年限、执业地点、执业类型或健康维护组织患者的比例而有所不同。只有6%的回复医生报告将β2激动剂支气管扩张剂作为首选治疗方法。本研究中的医生表示，他们在治疗不吸烟的急性支气管炎患者时，75%的情况下会开抗生素（无论是否为首选）。如果患者吸烟，医生报告说他们90%的情况下会开抗生素（F = 110.25；自由度 = 1；P >.0001）。医生报告说，与不吸烟者相比，吸烟者咳嗽完全缓解所需的时间更长，恢复到正常活动水平所需的时间也更长。
家庭医生报告说，抗生素是他们治疗健康状况良好的成年急性支气管炎患者最常用的方法。先前的临床试验表明，用抗生素治疗这种疾病的患者症状仅略有改善。随着抗生素耐药性成为一个主要的全球健康问题，评估其他治疗方法至关重要。
