BMJ 2001;322:939-940 ( 21 April )

Editorials

Antibiotics for acute bronchitis

Four reviews and still no answers: our clinical definitions are at fault

The first 150 words of the full text of this article appear below.

Acute bronchitis is one of the commonest medical problems managed by health services, and one of the important clinical questions is whether antibiotics do any good. Fittingly, for such a common problem, there have been four systematic reviews comparing antibiotics with placebo for treating bronchitis. All, however, have reached clinically unhelpful conclusions, which simply exposes the perennial problem for all systematic reviews that demonstrate no or only marginal benefits from the intervention: is there a subgroup that might derive benefit? It also exposes the procrustean nature of our definitions of acute bronchitis.^*

Three of the reviews included meta-analyses^1-3 and one was a qualitative systematic review of the literature.⁴ They include almost all the same studies, although Fahey et al² called their review a systematic review of acute cough in adults and included unpublished data from Stephenson. They all came to similar ambiguous and clinically unhelpful conclusions, the most negative . . . [Full text of this article]

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This article has been cited by other articles:

• Huang, N., Morlock, L., Lee, C.-H., Chen, L.-S., Chou, Y.-J. (2005). Antibiotic Prescribing for Children With Nasopharyngitis (Common Colds), Upper Respiratory Infections, and Bronchitis Who Have Health-Professional Parents. Pediatrics 116: 826-832 [Abstract] [Full text]  
• Macfarlane, J., Holmes, W., Gard, P., Thornhill, D., Macfarlane, R., Hubbard, R., van Weel, C. (2002). Reducing antibiotic use for acute bronchitis in primary care: blinded, randomised controlled trial of patient information leaflet * Commentary: More self reliance in patients and fewer antibiotics: still room for improvement. BMJ 324: 91-91 [Abstract] [Full text]  

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