TREATMENT OF ACUTE BRONCHITIS IN PRIMARY CARE

急性支气管炎是一种临床综合征， 排痰性咳嗽，伴有上呼吸道症状 在没有肺炎或潜在肺部疾病的情况下感染。 急性 支气管炎是最常见的疾病之一， 护理临床实践和治疗费用是巨大的。 最近 研究表明，肺炎支原体存在于一个显著的 急性支气管炎患者人数。 随机对照临床 抗生素的试验产生了相互矛盾的结果;适当的 治疗仍然不确定。 目标：本项目的目标是： 1.确定红霉素治疗在初级保健中的效用 没有潜在肺部疾病的急性支气管炎患者。 2.确定是否M。肺炎存在于大量的原发性 护理急性支气管炎患者。 3.确定新开发的快速M。肺炎抗体测试是 有助于预测哪些患者对红霉素治疗有反应。 方法：本研究为随机、前瞻性、双盲临床研究， 红霉素治疗急性支气管炎的临床观察 本研究将在三个不同的初级保健临床研究中心进行 在北卡罗来纳州。 所有患者都将接受抗M抗体检测。 肺炎使用新开发的快速测试以及传统的 急性和恢复期滴度通过补体结合。 患者将 最初和两周后再次观察，两次电话评估 监测副作用和治疗依从性 分析 根据对治疗的反应和根据是否存在 M. pneumoniae将提供信息，以满足规定的目标。 样本量计算表明，入组120例患者（各40例）， 场地）就足够了。

Acute bronchitis is a clinical syndrome characterized by an acute, productive cough, accompanied by evidence of an upper respiratory tract infection in the absence of pneumoniae or underlying lung disease. Acute bronchitis is one of the most frequently encountered illnesses is primary care clinical practice, and treatment costs are substantial. Recent studies suggest that Mycoplasma pneumoniae is present in a significant number of patients with acute bronchitis. Randomized, controlled clinical trials of antibiotics have yielded conflicting results; appropriate treatment remains uncertain. Objectives: The objectives of this project are to: 1. Determine the utility of treatment with erythromycin in primary care patients with acute bronchitis who have no underlying lung disease. 2. Determine if M. pneumoniae is present in a significant number of primary care patients with acute bronchitis. 3. Determine if a newly developed rapid M. pneumoniae antibody test is helpful in predicting which patients will respond to erythromycin therapy. Methods: This will be a randomized, prospective, double-blind clinical trial of erythromycin in the treatment of patients with acute bronchitis. The study will be performed at three different primary care clinical sites in North Carolina. All patients will be tested for antibodies to M. pneumoniae using a newly developed rapid test as well as the traditional acute and convalescent titers by complement fixation. Patients will be seen initially and again after two weeks, with two phone call assessments to monitor side effects and compliance in the interim. Analysis of the results according to response to therapy and according to the presence of M. pneumoniae will provide information to meet the stated objectives. Sample size calculations indicate that enrolling 120 patients (40 at each site) will be sufficient.