Patients aged 18 to 70, from nine primary care centers in Spain, with symptoms of a respiratory tract infection lasting less than one week, with cough as the main symptom, the presence of discolored sputum (the mucus coughed up from the lower respiratory tract) and at least one other symptoms of lower respiratory tract infection such as breathing difficulty, wheezing, chest discomfort or chest pain. The patients were randomly placed in three groups, ibuprofen 600 mg three times a day, amoxicillin-clavulanic acid 500 mg/125 mg three times a day and placebo three times a day for ten days. The number of days after treatment with a frequent cough was recorded.
The results demonstrated that there was no significant difference between the different treatments. The frequent cough lasted 9 days in patients taking ibuprofen and 11 days in patients taking placebo or amoxicillin-clavulanic acid. The authors concluded that anti-inflammatory and antibiotic treatment was not significantly effective in treating cough symptoms in patients with uncomplicated acute bronchitis.
I think this was a good study they did, to test if anti-inflammatories or antibiotics improve the most common symptom associated with patients who have lower respiratory tract infections, cough. This study, however, was unsuccessful in proving that anti-inflammatories or antibiotics improve cough symptoms in bronchitis patients. Since this article was published recently, I think there will potentially be more research with anti-inflammatories, antibiotics and the effect they have on bronchitis.
Source:
Efficacy of Anti-inflammatory or Antibiotic Treatment in Patients with Non-complicated Acute Bronchitis and Discoloured Sputum: Randomised Placebo Controlled Trial. BMJ, 4 Oct. 2013. Web. 08 Dec. 2013. <http://www.bmj.com/content/347/bmj.f5762.pdf+html>.
Source:
Efficacy of Anti-inflammatory or Antibiotic Treatment in Patients with Non-complicated Acute Bronchitis and Discoloured Sputum: Randomised Placebo Controlled Trial. BMJ, 4 Oct. 2013. Web. 08 Dec. 2013. <http://www.bmj.com/content/347/bmj.f5762.pdf+html>.
It’s very unfortunate that this study wasn’t successful since this disease is the most common reason for visits in primary care. I found it surprising that in the strengths and limitations section of this study it states that the researchers used drugs that have been on the market for more that 20 years. I agree with your prediction on how there will potentially be more research done with these anti-inflammatories and antibiotics. Hopefully something more effective can be discovered to improve the cough symptoms of this disease.
ReplyDeleteFrom my understanding, most cases of acute bronchitis are caused by a more viral process, which would thus make antibiotics not very effective, which would make sense that antibiotics may not necessarily work. However in the case of anti-inflammatory drugs, though it was not supported in this study that it improved cough, it probably helps with any other aches/pains or fevers that the individual is experiencing. I agree that there definitely should be more studies on other anti-inflammatory drugs to see if that helps to improve inflammation since bronchitis is marked by irritation and inflammation of the lining of the bronchial tubes.
ReplyDeleteI suppose my question would be the difference between the action of bronchodilators and anti-inflammatories. Because bronchodilators reduce inflammation and relax bronchial muscles to help with breathing, I would assume they ARE anti-inflammatories designed specifically to target the airway, whereas something like Ibuprofen is meant for systemic inflammation.
ReplyDeleteI think the issue the paper may have been trying to address is when a patient comes in with a cough do you give them the antibiotics they are asking for and make them happy, or do you give them ibuprofen to treat the symptoms? And I think this study answers that question nicely, give them the anti-inflammatory. It will make the patient feel better and it wont necessarily effect their recovery time...in fact in this study they tended to get better a whole 2 days faster.
ReplyDeleteInteresting how a two day improvement wasn't considered an improvement. My dad caught a nasty cough in Europe so I have some anecdotal evidence that an expectorant, squill from this stuff called chesty cough works miracles on alleviating cough symptoms. He found it in the UK and it wasn't sold here but it worked so well that now he has it shipped over lol.
ReplyDeleteI suppose my question would be the difference between the action of bronchodilators and anti-inflammatories. Because bronchodilators reduce inflammation and relax bronchial muscles to help with breathing, I would assume they ARE anti-inflammatories designed specifically to target the airway, whereas something like Ibuprofen is meant for systemic inflammation.
ReplyDeleteantibiotic