Bronchitis Tool Kit

HKC Bottom Line

• Patient satisfaction is dependent on the actual encounter with the health care provider as opposed to whether or not they receive an antibiotic prescription (Gonzales, 2001).

HKC Recommended Article

• Principles of Appropriate Antibiotic Use for the Treatment of Acute Bronchitis in Adults. Clear, concise recommendations on the approach to managing acute bronchitis. Part 2 of this article provides more extensive information.
  (Ann Int Med March 20, 2001;134(6):518-529).
  
  
• Azithromycin for acute bronchitis: A randomised, double-blind controlled trial. (2002) Evans T et al. (Lancet 2002;359(9318):1648-54)
  Further support that antibiotics are not effective. For brief summary of trial, click here.
  

Disease Overview

• American Family Physician. Diagnosis and Management of Acute Bronchitis (May 2002).

Management and Prescribing Advice

  General

• Johns Hopkins Antibiotic Guide
  Free access and provides the ability to search by pathogen, condition or antibiotic. Comprehensive and informative.
  
  
• Annals of Internal Medicine. Principles of Appropriate Antibiotic Use for the Treatment of Upper Respiratory Tract Infections in Adults (Mar 2001). Provides evidence and recommendations about differentiating between bacterial and viral causes of acute bronchitis and when using antibiotics is beneficial.

  Cough

• ICES. Diagnosing and Managing Subacute Cough (Mar 2001).
  
  
• ICES. Diagnosing and Managing Acute Cough (Mar 2001). Provides various treatment options for the various causes of acute cough.
  
  
• ICES. Diagnosis and Treatment of Chronic Cough in Adults (Mar 2001). Includes a treatment chart summarizing the treatment of common causes of chronic cough and an algorithm for evaluating chronic cough.

  Drug Specific

• Refer to the HKC table for a selection of antitussives with recommended doses and side effects.

Algorithms

• American Family Physician. Management of Acute Bronchitis-Algorithm (May 2002).
  

Guidelines

• None available

Patient Resources

  Printable Patient Handout

• Acute Bronchitis and Antibiotics. 1-page printable patient information. This concise information sheet could be useful for educating patients why you may not be prescribing antibiotics for their cough.
  
  
• AAFP. Acute Bronchitis. 2-page printable patient information, excellent format and content for educating patients.
  
  
• American Society for Microbiology Centers for Disease Control and Prevention. A New Threat to your Health: Antibiotic Resistance. Useful pamphlet for patients.
  
  
• Acute Bronchitis and Antibiotics. Educational poster to use in your office to assist in explaining to patients why you are not prescribing antibiotics. The graphics are effective in helping patients understand the lack of efficacy of antibiotics for acute bronchitis as well as the increased risk of creating antibiotic resistant bacteria in our communities.

Tools

• BMJ Clinical Trial Information. New research shows that azithromycin is no better than vitamin C for acute bronchitis (May 2002). Use BMJ's news release as a way to educate your patients on the lack of antibiotic efficacy.