The problem statement is centered around the efficacy and plausibility of antibiotics usage for acute bronchitis. The search for evidence yields a mix of results, which is why the literature review was critical in order to derive a properly assessed and analyzed conclusion and recommendations. The quality and reliability of evidence play a central role in basing the suggested practice changes on the principles of evidence-based practice or EBP. The core recommendation is that antibiotics should not be used as commonly and prevalently as they are used now when treating acute bronchitis in order to avoid contributing to an increase in bacterial resistance.
The first recommendation is to limit the use of antibiotics among patients with acute bronchitis. It is stated that there is no statistically significant difference between the use of antibiotics for acute bronchitis and avoidance of its usage when it comes to clinical outcomes (Smith et al., 2017). Therefore, the nursing practice should be more reluctant to give antibiotics to patients with the condition. Literature supports the fact that “it is especially important for clinicians to share the decision about whether to use antibiotics or not with their patients” (Smith et al., 2017, p. 15). However, antibiotics had a positive effect in the case of cough occurrence, night cough, and additional beneficial outcomes (Smith et al., 2017). In other words, antibiotics can only be prescribed in case of severe coughs among patients diagnosed with acute bronchitis.
The second recommendation is to improve the diagnostic precision through a more detailed and accurate protocol of acute bronchitis assessment. The reviewed literature recommends that in order “to reduce the apparent systemic under-diagnosis of asthma and the emerging antibiotic resistance, adequate training in LTR-illnesses and management for asthma/wheeze can be an essential contribution” (Østergaard et al., 2018, p. 6). Thus, the current system of acute bronchitis treatment is more relaxed about antibiotics prescription because the identification of the nature of the disease is not precise. A qualitative study reveals that some healthcare professionals state: “if a child has a cough and shortness of breath, usually depending on the child’s condition, I prescribe antibiotics” (Østergaard et al., 2018, p. 4).” In other words, the key missing step is the lack of verification of the nature of the disease. Antibiotics are only effective against bacterial bronchitis, and even then, it is not guaranteed to improve symptoms. Therefore, such a disregard for the proper diagnosis of individuals with the condition contributes to the development of microbial resistance to antibiotics.
In conclusion, acute bronchitis is a complex problem, and antibiotics’ efficacy against the latter is limited, which is why its use is unjustified. Firstly, antibiotics should only be given to such patients only if they have a severe cough due to bacterial infection. Secondly, more precise and accurate diagnostic measures need to be implemented in order to justify the use of antibiotics. The literature clearly supports these recommendations because antibiotics are overused, and their efficacy is overestimated.
References
Østergaard, M. S., Kjærgaard, J., Kristensen, M. M., Reventlow, S., Poulsen, A., Isaeva, E., Akylbekov, A., & Sooronbaev, T. (2018). Recurrent lower respiratory illnesses among young children in rural Kyrgyzstan: Overuse of antibiotics and possible under-diagnosis of asthma. A qualitative FRESH AIR study. NPJ Primary Care Respiratory Medicine, 28(1), 1-8.
Smith, S. M., Fahey, T., Smucny, J., & Becker, L. A. (2017). Antibiotics for acute bronchitis. Cochrane Database of Systematic Reviews, 6(6), 1-59.