Abstract—Background: Although the overuse of antibiotics
and underuse of bronchodilators for treatment of acute
bronchitis is well known, few studies have analyzed these trends
in the emergency department (ED). Study Objectives: To characterize
the antibiotic and bronchodilator prescribing practices
of physicians at two academic EDs in the diagnosis of
acute bronchitis, and to identify factors that may or may not
be associated with these practices. Methods: A computer database
was searched retrospectively for all patients with an ED
discharge diagnosis of acute bronchitis, and analyzed, looking
at the frequency of antibiotic prescriptions, the class of antibiotic
prescribed, and several other related factors including age,
gender, chief complaint, duration of cough, and comorbid conditions.
Results: During the study period, there were 836 cases
of acute bronchitis in adults. Of these, 622 (74.0%) were prescribed
antibiotics. Of those prescribed antibiotics, 480
(77.2%) were prescribed broad-spectrum antibiotics. Using
multivariate analysis (odds ratio, 95% confidenceinterval), antibiotics
were prescribed significantly more often in patients
aged 50 years or older (1.7, 1.2–2.5) and in smokers (1.5, 1.0–
2.2). Of patients without asthma, 346 (49.9%) were discharged
without a bronchodilator, and 631 (91.1%) were discharged
without a spacer device. Conclusion: Antibiotics are overprescribed
in the ED for acute bronchitis, with broadspectrum
antibiotics making up the majority of the antibiotics
prescribed. Age $ 50 years and smoking are associated with
higher antibiotic prescribing rates. 2012 Published by
Elsevier Inc.