Role of Atypical Pathogens and the Antibiotic Prescription Pattern in Acute Bronchitis: A Multicenter Study in Korea

J Korean Med Sci. 2015 Oct;30(10):1446-52. doi: 10.3346/jkms.2015.30.10.1446. Epub 2015 Sep 12.

Abstract

The role of atypical bacteria and the effect of antibiotic treatments in acute bronchitis are still not clear. This study was conducted at 22 hospitals (17 primary care clinics and 5 university hospitals) in Korea. Outpatients (aged ≥ 18 yr) who had an acute illness with a new cough and sputum (≤ 30 days) were enrolled in 2013. Multiplex real-time polymerase chain reaction (RT-PCR) was used to detect five atypical bacteria. A total of 435 patients were diagnosed as having acute bronchitis (vs. probable pneumonia, n = 75), and 1.8% (n = 8) were positive for atypical pathogens (Bordetella pertussis, n = 3; B. parapertussis, n = 0; Mycoplasma pneumoniae, n = 1; Chlamydophila pneumoniae, n = 3; Legionella pneumophila, n = 1). Among clinical symptoms and signs, only post-tussive vomiting was more frequent in patients with atypical pathogens than those without (P = 0.024). In all, 72.2% of the enrolled patients received antibiotic treatment at their first visits, and β-lactams (29.4%) and quinolones (20.5%) were the most commonly prescribed agents. In conclusion, our study demonstrates that the incidence of atypical pathogens is low in patients with acute bronchitis, and the rate of antibiotic prescriptions is high.

Keywords: Acute Bronchitis; Antibiotics; Atypical Pathogens; Korea.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bordetella parapertussis / genetics
  • Bordetella parapertussis / isolation & purification*
  • Bordetella pertussis / genetics
  • Bordetella pertussis / isolation & purification*
  • Bronchitis / drug therapy
  • Bronchitis / microbiology*
  • Chlamydophila pneumoniae / genetics
  • Chlamydophila pneumoniae / isolation & purification*
  • Community-Acquired Infections / microbiology
  • Female
  • Humans
  • Hypertension / complications
  • Legionella pneumophila / genetics
  • Legionella pneumophila / isolation & purification*
  • Male
  • Middle Aged
  • Mycoplasma pneumoniae / genetics
  • Mycoplasma pneumoniae / isolation & purification*
  • Real-Time Polymerase Chain Reaction
  • Republic of Korea
  • Sputum / microbiology

Substances

  • Anti-Bacterial Agents