Antibiotics are unnecessary to treat acute bronchitis according to clinical trial

Barcelona (ACN).- A clinical trial conducted in nine Catalan health care centres and published in the ‘British Medical Journal’ found that “in the case of mild respiratory infections such as acute bronchitis, there is a misuse of antibiotics, which is of no benefit to patients, and only helps increasing resistance to these drugs”. Such was the conclusion of the study coordinated by Marc Miravitlles, leading researcher at the Pneumology unit of Barcelona’s Vall d’Hebron Research Centre (VHIR). From 2010 to 2012, 416 patients, who had several signs of acute bronchitis - an inflammation of the bronchi with cough as the main symptom - were randomly assigned one of three different treatments. The main conclusion was that antibiotics, the most widely prescribed treatment for this type of illness, are ineffective. Furthermore, the study also demonstrated that anti-inflammatory treatments increased in a minimal way the chances of ending coughs faster.

The trial was conducted from 2010 to 2012 on 416 patients, aged between 18 and 70 years, who had no prior respiratory diseases, and showed symptoms of acute respiratory infection of their lower airways. According to the researchers, all patients had cough as the main symptom, changes in the colour of the sputum, and at least one other criterion of respiratory infection, such as dyspnoea (respiratory distress) and hissing, breathing discomfort or chest pains.

Three different treatments

With the consent of their patients, doctors randomly assigned a treatment to each of them, without being aware of which one it was but having their agreement to participate in the trial. During 10 days: some patients were treated with the amoxicillin - clavulanic acid antibiotic (500mg/125mg), which is widely prescribed in these cases, while others took ibuprofen anti-inflammatory, and the third group was given a placebo.

Out of the total number of patients, 390 got rid of the persistent cough in less than two weeks. For patients treated with anti-inflammatory drugs, the coughing stage lasted between 8 and 10 days, for those treated with antibiotics, it lasted between 10 and 12 days, and for those who took placebo, between 8 and 14 days.

Antibiotics of “no benefit”

Given these results, Dr. Miravitlles warned that “in the case of mild respiratory infections such as acute bronchitis, there is a misuse of antibiotics, which is of no benefit to patients, and only helps increasing resistance to these drugs”. Indeed, prescribing antibiotics for acute bronchitis is a very widespread practice. Given the disease is one of the most frequent causes for medical visits, such misuses results in significant costs, as well as high risks of having side effects and increased chances of developing resistance to common bacteria.

Ibuprofen reduces the duration of symptoms in a very minimal way

Dr. Carl Llor, who also coordinated the clinical trial, said that anti-inflammatory drugs were another matter altogether because they are not as harmful to the general population as antibiotics are. “Regarding ibuprofen, we saw a trend towards a reduction of the duration of bronchitis symptoms, but it was not significant” explained the researcher. He did not rule out that patients with severe symptoms could benefit from a treatment that, even if it does not cure the disease, can help hinder its development.

The clinical trial was carried out in medical centres in Bon Pastor, La Marina, Passeig Maragall (all three in Barcelona), Gatassa, Rocafonda-Palau, Pineda de Mar, Tordera, (all four in the Province of Barcelona), Valls-urbà and Jaume I (both in Tarragona Province, southern Catalonia).