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

• Park S
• Oh KC
• Kim KS
• Song KT
• Yoo KH
• Shim YS
• Lee YJ
• Lee MG
• Yun JU
• Kim HS
• Kim YH
• Lee WJ
• Kim DI
• Cha HG
• Lee JM
• Seo JS
• Jung KS

• KMID: 2344177
• DOI: http://doi.org/10.3346/jkms.2015.30.10.1446

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

MeSH Terms

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

Figure

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  Fig. 1 Flow diagram of enrolled patients.

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  Fig. 2 Frequency of clinical symptoms among patients with acute bronchitis (n = 435).

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  Fig. 3 Freuqency of antibiotic prescriptions by participating physicians.

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