Effects of Antibiotics for Patients with Acute Bronchitis
The purpose of this assignment is to write a review of the research articles you evaluated in your Topic 5 "Evidence-Based Practice Project: Evaluation of Literature" assignment.
A literature review provides a concise comparison of the literature for the reader and explains how the research demonstrates support for your PICOT.
In a paper of 1,250-1,500, select eight of the ten articles you evaluated that demonstrate clear support for your evidence-based practice and complete the following for each article:
Introduction - Describe the clinical issue or problem you are addressing. Present your PICOT statement.
Search methods - Describe your search strategy and the criteria that you used in choosing and searching for your articles.
Synthesis of the literature - For each article, write a paragraph discussing the main components (subjects, methods, key findings) and provide rationale for how the article supports your PICOT.
Comparison of articles - Compare the articles (similarities and differences, themes, methods, conclusions, limitations, controversies).
Suggestions for future research: Based on your analysis of the literature, discuss identified gaps and which areas require further research.
Conclusion - Provide a summary statement of what you found in the literature.
You are required to cite eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
An abstract is not required.
*** I have attached past assignments related to this topic. Thank you
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Acute bronchitis is a condition that is prevalent during the influenza season, with 90% of those patients requiring medical consultation. It is also one of the common causes of hospitalizations worldwide, amounting to over ten million patients diagnosed with lower respiratory tract infection, specifically acute bronchitis (Singh et al., 2021). Antibiotics are often used to address the coughing symptoms of the patient. However, it is also associated with side effects such as vomiting, allergic reactions, nausea, and Clostridium difficile infection (Mohsen et al., 2020). In the nursing practice, this issue is significant. It requires evidence-based care practice to decrease the negative side effects of antibiotics that are used to treat patients with acute bronchitis while decreasing the length of the disease and its associated symptoms.
In patients with acute bronchitis (Population), how effective are antibiotics (Intervention) in comparison to supportive treatment (Comparison) in decreasing the disease burden and length of illness (Outcome) in 7 days of treatment (Time)?
Search Methods
The research databases that are used are PubMed, ScienceDirect, Google Scholar, and ProQuest. The search terms used are the following: acute bronchitis, respiratory tract infection, coughing symptoms of acute bronchitis, traditional treatment, supportive treatment, antibiotics, side effects, and decreasing length of illness. Peer-reviewed articles are specifically chosen as literature for this research. The research studies have been published within the last five years.
Synthesis of the Literature
A research study about the pattern of outpatient prescriptions for acute bronchitis shows that there is a significant number of unnecessary prescriptions of antibiotics, reaching up to 44% of all the outpatient prescriptions for antibiotics in the United States. This research argues that this does not result in any clinical improvement while also increasing the incidence of antibiotic resistance in the population. It is also worth considering that the symptoms of acute bronchitis are self-limiting within two to three weeks. Results show that for adult patients 18 years old and above, the common treatment included 46.4%, while 65.2% represent symptom management medications such as traditional Chinese medicines, antihistamines, and expectorants. Supportive care for acute bronchitis symptoms is considered an effective treatment option for most acute bronchitis patients. The study concludes that the number of antibiotic prescriptions is much higher than what is indicated in the treatment guidelines, and targeted interventions are suggested to improve the practice (Fu et al., 2021).
The inappropriate prescription of antibiotics is also found to affect the patient’s subsequent episodes of acute bronchitis. Based on the retrospective analysis of pediatric patients having an initial acute bronchitis episode, those who were administered with prescribed antibiotics developed a pattern of increased subsequent episodes compared to those who were not immediately prescribed antibiotics on their first consultation for acute bronchitis. In line with this, antibiotic prescriptions can be a strong predictor of the future episodes and consultation of the patients (Morgan et al., 2019).
Coughing is a symptom associated with acute bronchitis due to the inflammation of the airways without the diagnosis of pneumonia. It has signs of lower respiratory tract infection and is often treated with antibiotics. In the study that aims to compare the rate of prescribing antibiotics for general acute respiratory infections, it appeared to be seven to nine times higher than the recommendation of health guidelines, and it is more suitable for conditions such as community-acquired pneumonia, acute rhinosinusitis, otitis media, acute pharyngitis, and pertussis. The study concludes that there should be a set limit in prescribing antibiotics to abide by the health guidelines for proper acute bronchitis and other respiratory condition management (McCullough et al., 2017).
Prescribing antibiotics are very common even in uncomplicated cases of acute bronchitis, and addressing the issue has already been a global priority in healthcare. Results show that broad-spectrum antibiotics are often prescribed for up to 97.8% of all antibiotic prescriptions. Macrolides, most often azithromycin, are prescribed for a mean duration of 5.1. The age group that is commonly prescribed antibiotics for acute bronchitis are those in the middle age group, who are 18 to 39 years of age, that is 66.9% of the population in the study. This may be associated with drug resistance and also side effects such as nausea, bloating, vomiting, etc. (Grigoryan et al., 2017).
A randomized clinical trial studies in a pediatric setting about the effectiveness of targeted interventions for treating bronchiolitis symptoms such as coughing and wheezing. The main interventions in the study are targeted educational delivery, site-based clinical leads, stakeholder meetings, audit, and feedback. These targeted interventions improve symptoms in the 26 hospitals with patients who have respiratory symptoms. In addition, the study involves stopping the potentially harmful treatment management that is commonly used, such as antibiotics, albuterol, and glucocorticoids (Haskell et al., 2021).
Symptom management is a w...