Antibiotic Therapy of Acute Exacerbations of Chronic Bronchitis

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Abstract
A double-blind, randomized, placebo-controlled trial in 40 patients was conducted to evaluate the need for antibiotics in acute exacerbations of chronic bronchitis. All patients were sufficiently ill to require hospitalization although none needed ventilatory support; the presence of pneumonia was excluded. Treatment consisted of bronchodilators, corticosteroids and tetracycline, 500 mg, or placebo by mouth every 6 h for 1 wk. Arterial blood gases, spirometric tests, bacteriologic evaluation of sputum, and patient and physician evaluation of the severity of illness were assessed at the beginning and end of the study. All patients improved symptomatically and by objective measures of lung function. At the end of the study period there were no differences between those patients receiving tetracycline and those receiving placebo. Antibiotic therapy is not needed in moderately ill patients with exacerbations of chronic bronchitis.

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