急性支气管炎与抗生素（英文PPT）Areantibiotics of Value in the treatment of .pptVIP

Conclusion: Antibiotics have only a modest effect on the duration of cough (by a fraction a day) compared with placebo. There were no significant differences regarding the presence of night cough, productive cough or activity limitations at follow up or in the mean duration of activity limitations. Fahey T, Smucny J, Becker L, Glazier R. Antibiotics for acute bronchitis. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD000245 Conclusion: Non significantly increase in the adverse events attributed to antibiotics. Data on subsets of patients who may benefit more from treatment is lacking. Fahey T, Smucny J, Becker L, Glazier R. Antibiotics for acute bronchitis. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD000245 If pertussis is suspected: Empiric antibiotic (Macrolides) may be initiated while obtaining a diagnostic test for confirmation. Antibiotic treatment decreases transmission, but has little effect on cough resolution if started after 10 days of illness. American College of Physicians 2001: Antibiotic treatment is “not recommended, regardless of duration of cough.” American College of Chest Physicians 2006: Routine treatment with antibiotics is not justified. Centers for Disease Control and Prevention (CDC) Antibiotics only indicated in Pertussis. Antibiotics are recommended: Symptoms and signs suggesting pneumonia Those at high risk of serious complications because of pre-existing comorbidities (including patients with heart, lung, renal, liver, or neuromuscular disease, immunosuppression, or cystic fibrosis and young children who were born prematurely) Patients 65 years, if they had: Hospitalization in the past year. Diabetes mellitus. Congestive heart failure. On steroids. BMJ?2008;?337:a437 Patients who have cough and sputum production on most days of the month for at least 3 months of the year during 2 consecutive years. Acute exacerbation of chronic bronchitis (AECB): “A sustained worsening of the patient