Assessment of the Prescribing Pattern of Antibiotics with Corticosteroids in Infective Acute Exacerbation of Chronic Bronchitis - A Case Series

Chronic bronchitis has significant impact on morbidity.. The present study was conducted to assess the prescribing pattern of antibiotics along with systemic corticosteroids and the rationality of treatment in AECB patients. A six months retrospective study was conducted by assessing eighty one cases admitted to medical wards at a government secondary care hospital in Nilgiris, Tamil nadu. The average age of patients reported 50.58 years treated for duration of 11.58 days. 88.89% were smokers, 82.71% alcoholic and 59.25% tobacco/pan masala chewers. The most prescribed antibiotic was Cefotaxime. Others include- Cefixime, Ceftriaxone, Cephalexin, Amoxicillin, Ampicillin, Garamycin and Azithromycin. Most frequently prescribed systemic corticosteroids were Dexamethasone and Prednisolone. An average of 2.19 antibiotics was prescribed for AECB management. Increase in duration of treatment for individual patient was due to non-specific prescription. The prescribing of corticosteroids along with antibiotics could not reduce treatment duration because microbial inflammation was not controlled with antibiotics prescribed for them. It concluded that prescribing pattern of drugs is irrational. The increasing levels of antibacterial resistance among common respiratory tract pathogens implicated in AECB may threaten use of many currently recommended treatment options and has highlighted the need for alternative antibacterial agents.