Antibiotic treatment of acute bronchitis in smokers: A systematic review

Jeffrey A. Linder*, Ida Sim

*Corresponding author for this work

Research output: Contribution to journalReview article

31 Scopus citations

Abstract

OBJECTIVE: Community physicians in the United States prescribe antibiotics to 80% to 90% of smokers with acute bronchitis. We performed a systematic review of the literature to determine the efficacy of antibiotics for smokers with acute bronchitis. DESIGN: A MEDLINE search was done using the keywords bronchitis, cough, and antibiotics to identify English language articles published from January 1966 to September 2001. Randomized, placebo-controlled trials of antibiotics in previously healthy smokers and nonsmokers with acute bronchitis were included. MEASUREMENTS AND MAIN RESULTS: For each study, we abstracted information on design, size, inclusion criteria, patient characteristics, and outcomes. Of 2,029 articles in the original search, 109 relevant articles were retrieved and reviewed. There have been no studies specifically addressing antibiotic use in smokers with acute bronchitis. Nine randomized, placebo-controlled trials of antibiotics have included 774 patients and over 276 smokers. Lack of subgroup reporting for smokers precluded meta-analysis. In 7 trials, smoking status did not predict or alter patients' response to antibiotics. In one trial, trimethoprim/sulfamethoxazole resulted in less-frequent cough overall, but not among smokers. In another trial, erythromycin reduced symptom scores only among nonsmokers while antibiotic-treated smokers had a trend toward higher symptom scores. CONCLUSION: Although no trials have specifically addressed antibiotic use in smokers with acute bronchitis, existing data suggest that any benefit of antibiotics is the same or less for smokers than for nonsmokers.

Original languageEnglish (US)
Pages (from-to)230-234
Number of pages5
JournalJournal of general internal medicine
Volume17
Issue number3
DOIs
StatePublished - Jan 1 2002

Keywords

  • Bronchitis, antibiotics
  • Smoking
  • Systematic review

ASJC Scopus subject areas

  • Internal Medicine

Fingerprint Dive into the research topics of 'Antibiotic treatment of acute bronchitis in smokers: A systematic review'. Together they form a unique fingerprint.

  • Cite this