Faut-il traiter par antibiotiques les bronchites aiguës de l’adulte sain ou du bronchitique chronique non insuffisant respiratoire? Par quelles molécules? Chez quels types de patients?

Les mucorégulateurs dans les syndromes bronchiques aigus : point sur les pratiques en médecine générale et les données de la littérature

Antibiotics have long been used in the initial treatment of acute bronchitis (AB) and acute exacerbations of chronic bronchitis (AECB). However, their lack of value in AB has been clearly demonstrated and antibiotic therapy is justified in only a few cases of AECB. In parallel, although the value of mucoregulators in these diseases is still debated, their prescription remains important in general practice. In this context, our aim was to determine the prescribing behaviour of general practitioners (GPs) with regard to these drugs, as well as the beliefs of GPs concerning the place of mucoregulators in the treatment of AB in children and adult smokers, as well as in patients with non-obstructive AECB. A survey was carried out in 370 GPs, who were presented with three standardised and computerised medical cases: (i) rhinopharyngitis + AB in a child; (ii) AB in an adult smoker without a previous medical history; and (iii) a patient with non-obstructive AECB. The results showed that mucoregulators are frequently prescribed by GPs for children and adults with AB, or in AECB. This high prescribing rate is due to the belief of the GPs that these drugs are effective and well tolerated, which is confirmed by the literature. Their use avoids the frequent and unjustified prescription of antibiotics in situations where they are not recommended but where the patients request drug therapy.