Populaire antibiotica is zinloos bij bronchitis.*

Patiënten die lijden aan bronchitis zijn niet beter af door toediening van antibiotica als patiënten die een lage dosis vitamine C krijgen. Van deze lage dosis vitamine C is bekend dat die niet effectief is tegen bronchitis. De toediening van antibiotica lijkt alleen geringe klinische voordelen te geven, welke helemaal niet opwegen tegen mogelijke bijwerkingen. Volgens Dr. Arthus Evans is het bewijs nu geleverd dat antibiotica zinloos is bij acute bronchitis.

Patients suffering from bronchitis who were given a widely prescribed antibiotic did no better than patients who took a low dose of vitamin C, which is known to be ineffective in treating bronchitis, researchers report. "Antibiotics don't work for acute bronchitis," lead author Dr. Arthur Evans, an associate chair of medicine at Cook County Hospital in Chicago, Illinois, told Reuters Health. "Now we have strong evidence saying that it shouldn't be used for this purpose." The researchers hoped to test the effectiveness of antibiotics for patients with acute bronchitis. Physicians commonly prescribe antibiotics to treat this condition, but prior studies of whether antibiotics help patients with bronchitis have had mixed results. At random, the researchers gave 220 patients with acute bronchitis either the antibiotic azithromycin or a dummy pill of low-dose vitamin C, which has been shown to have no effect on bronchitis. The patients were also given standard therapy for bronchitis, including cough syrup and an albuterol inhaler to ease their cough. The investigators measured whether the patients given the antibiotic showed improvements in their quality of life, such as being able to return to normal activities after a week. The findings are published in the May 11th issue of the medical journal The Lancet. Evans and colleagues found that after 7 days, the patients given the antibiotic and those given vitamin C did not differ significantly in their physical improvement and the timing of their return to regular activity. The patients receiving the antibiotic showed only a slight improvement in coughing and daily activities by the third day of treatment, but those differences disappeared by the seventh day. The authors conclude that antibiotics appear to provide only "transient benefit of little clinical significance," while increasing the risk of side effects and microbial resistance to the medication. The findings shift the burden of proof to proponents of antibiotics to demonstrate why these drugs should be used in acute bronchitis, the researchers note. In the meantime, Evans suggests doctors should not routinely prescribe antibiotics for bronchitis. "If the condition changes and there's suspicion of pneumonia, the patient should be reassessed," Evans added. "Sometimes pneumonia is misdiagnosed as acute bronchitis." SOURCE: The Lancet 2002;359:1648-1654. (mei 2002)

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