J Korean Med Sci.  2015 Oct;30(10):1446-1452. 10.3346/jkms.2015.30.10.1446.

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

Affiliations
  • 1Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea. pulmoks@hallym.ac.kr
  • 2Myeongmun Clinic of Internal Medicine, Yongin, Korea.
  • 3Joeun Clinic of Internal Medicine, Dangjin, Korea.
  • 4Neulpurun Clinic of Otolaryngology, Anyang, Korea.
  • 5Division of Pulmonary, Allergy and Critical Care Medicine, Konkuk University Hospital, Seoul, Korea.
  • 6Division of Pulmonary, Allergy and Critical Care Medicine, Kangnam Sacred Heart Hospital, Seoul, Korea.
  • 7Pyeongchon-Family Clinic of Internal Medicine, Anyang, Korea.
  • 8Division of Pulmonary, Allergy and Critical Care Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
  • 9Haengbok-Dream Clinic of Internal Medicine, Daegu, Korea.
  • 10Hanyang Clinic of Internal Medicine, Seoul, Korea.
  • 11Division of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University, Seoul, Korea.
  • 12Hongjunggon Clinic of Internal Medicine, Anyang, Korea.
  • 13Rapha Clinic of Otolaryngology, Anyang, Korea.
  • 14Chahyunggun Clinic of Otolaryngology, Anyang, Korea.
  • 15Leejaemyung Clinic of Internal Medicine, Anyang, Korea.
  • 16Seojungsan Clinic of Internal Medicine, Seoul, Korea.

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 > or = 18 yr) who had an acute illness with a new cough and sputum (< or = 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 beta-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.

Keyword

Acute Bronchitis; Antibiotics; Atypical Pathogens; Korea
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