TREATMENT OF ACUTE BRONCHITIS IN PRIMARY CARE

急性支气管炎是一种临床综合征，其特征是急性、 活动性咳嗽，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，是原发病 护理临床实践中，治疗费用是相当可观的。近期 研究表明，肺炎支原体存在于一种显著的 急性支气管炎患者数量。随机对照临床试验 抗生素试验产生了相互矛盾的结果；适当的 治疗方法仍不确定。 目标：该项目的目标是： 1.确定红霉素治疗在初级保健中的效用 无肺部基础疾病的急性支气管炎患者。 2.确定肺炎支原体是否存在于相当数量的初级卫生组织中 护理急性支气管炎患者。 3.确定一种新开发的肺炎支原体抗体快速检测方法是否 有助于预测哪些患者对红霉素治疗有反应。 方法：这是一项随机、前瞻性、双盲临床试验。 红霉素治疗急性支气管炎的临床研究。 这项研究将在三个不同的初级保健临床地点进行 在北卡罗来纳州。所有患者都将接受M抗体检测。 使用一种新开发的肺炎快速检测方法以及传统的 补体结合法测定急性期和恢复期滴度。病人将会是 最初和两周后再次看到，并进行了两次电话评估 在此期间监测副作用和遵从性。三、分析了 结果根据对治疗的反应和根据是否存在 肺炎支原体将提供信息以实现所述目标。 样本量计算表明，招募120名患者(每人40名 站点)将是足够的。

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.