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

• Published in: Journal of Korean medical science Vol. 30; no. 10; pp. 1446 - 1452
• Main Authors: Park, Sunghoon, Oh, Kil Chan, Kim, Ki-Seong, Song, Kyu-Tae, Yoo, Kwang Ha, Shim, Yun Su, Lee, Young Ju, Lee, Myung Goo, Yun, Jang Uk, Kim, Hyun Su, Kim, Yee Hyung, Lee, Won Jun, Kim, Do Il, Cha, Hyung Gun, Lee, Jae-Myung, Seo, Jung San, Jung, Ki-Suck
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.10.2015; 대한의학회
• Subjects: Anti-Bacterial Agents - therapeutic use; Bordetella parapertussis - genetics; Bordetella parapertussis - isolation & purification; Bordetella pertussis - genetics; Bordetella pertussis - isolation & purification; Bronchitis - drug therapy; Bronchitis - microbiology; Chlamydophila pneumoniae - genetics; Chlamydophila pneumoniae - isolation & purification; Community-Acquired Infections - microbiology; Female; Humans; Hypertension - complications; Legionella pneumophila - genetics; Legionella pneumophila - isolation & purification; Male; Middle Aged; Mycoplasma pneumoniae - genetics; Mycoplasma pneumoniae - isolation & purification; Original; Real-Time Polymerase Chain Reaction; Republic of Korea; Sputum - microbiology; 의학일반; Republic of Korea; Acute Bronchitis; Antibiotics; Atypical Pathogens; Korea
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2015.30.10.1446

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 ≥ 18 yr) who had an acute illness with a new cough and sputum (≤ 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 β-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.