Antibiotics of less use for bronchitis

People with acute uncomplicated lower respiratory tract infection who are prescribed antibiotics get better only slightly faster than similar patients who are not given antibiotics. It is difficult to justify widespread antibiotic prescribing for uncomplicated lower respiratory tract infection on this basis given the dangers of antibiotic resistance. Researchers from the University of Southampton, England, recruited patients with cough and one other lower respiratory tract symptoms such as sputum, chest pain, breathlessness or wheeze. A total of 807 patients were randomly assigned to immediate antibiotics, no antibiotics, or delayed antibiotics to be used if symptoms did not resolve. Daily symptoms diaries were returned by 562 patients after 3 weeks, and another 78 patients provided information about symptom duration and severity. Antibiotic treatment had no effect on overall duration of cough, although immediate prescription of the drugs reduced duration of moderately bad symptoms by approximately 1 day. Only one patient developed pneumonia requiring hospitalisation. It was found that more patients (86 percent) in the immediate antibiotic group reported being 'very satisfied', compared with 77 percent in the delayed group and 72 percent in the no-antibiotic group. However, fewer of these patients believed the antibiotics were effective. It is recommended that physicians who feel compelled to give an antibiotic should at least use the tactic of delayed prescriptions to mitigate the effects of this prescribing error.