PICOT: Acute Bronchitis

PICOT Final
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Population
Demographics
The annual prevalence of acute bronchitis is 5%, and most of the patients are diagnosed during the influenza season. Ninety percent of the 5% with the disease are prompted for consultation. In the United States, it is more prevalent during autumn and winter compared to other seasons. The disease is one of the significant causes of hospital visits globally, with over 10 million patients consulting with lower respiratory tract infection, particularly acute bronchitis (Singh et al., 2021; Fu et al., 2021).
Some of the risk factors include exposure to allergens and pollutants, overcrowding, and a history of smoking and asthma (Singh et al., 2021). Park et al. (2016) suggest that there has been a debate on the pathogenic agent that usually cause acute bronchitis. Some studies revealed that viruses are the etiologic agents in 8 to 23% of community cases. However, other researchers found that bacteria are the most common cause, where 25.9% are secondary to typical bacterial while 23.7% are secondary to atypical bacteria. Sputum examination also revealed a bacterial infection in 45% of the cases.
Studies have shown that respiratory diseases, including the upper and lower respiratory tract, are leading causes of workplace absences. Additionally, this also results in poor work efficiency and an increased cost for the organization (Middeldorp et al., 2020).
Health Concerns
Acute bronchitis results in difficulty breathing, blood-tinged or rusty sputum, increased cardiac rate, typically more than 100 beats per minute (bpm), tachypnea greater than 24 cycles per minute (cpm), and increased body temperature. Other findings include increased tactile fremitus and lung consolidation (Kinkade & Long, 2016).
Some of the health concerns include the progression of the disease to a lower respiratory tract infection, disease transmission, especially in closed or small spaces, presence of comorbidities, and poor immunization (Singh et al., 2021).
Intervention
Antibiotics
Fu et al. (2021) stated that antibiotic abuse had been seen in the treatment of acute bronchitis. This accounts for 70% of the time, affecting 44% of the patients, predisposing them to antibiotic resistance and increased healthcare costs. Moreover, antibiotic prescription proved no clinical advantage as most of the cases are secondary to viral infections.
The most frequently used antibiotics in metropolitan areas include second-generation and third-generation cephalosporins and macrolides in China. By contrast, rural doctors prescribe third-generation cephalosporins, broad-spectrum penicillin, and macrolides (Fu et al., 2021). According to Morley et al. (2020), the most common findings that encourage its prescription include percussion dullness and the presence of rhonchi.
Health Policies and Health Care Equity
Roberts et al. (2016) explained that the use of broad-spectrum antibiotics might be detrimental to the patient’s health as this causes antibiotic resistance, preventing the patients from gaining benefit from these drugs in the future. Due to the threat to health safety, the Healthcare Effectiveness Data and Information Set (HEDIS) pr...