Ukrainian internists notions’ analysis on dignostics and treatment of acute bronchitis

Abstract

Actuality. Physicians’ mistakes in diagnostics and treatment of acute bronchitis (AB) lead to unjustified medicines’ expenses and can negatively influence on spread of antimicrobial resistance.Aim of the study – to propose approaches to improvement of diagnostics and treatment of patients with AB in Ukraine on the basis of physician notions’ analysis.Materials and methods. There were formulated 8 questions to physician’ inquiry with 5 variants of responses to each of them. Physicians defined right responses to each of the questions by themselves. During 2018 year 201 internists were inquired at physician’s conferences and courses of postgraduate education.Results. Less than one third respondents (29.6 %) chose no need in laboratory and instrumental investigations to verify the diagnosis of AB, meanwhile much more physicians pointed at necessity of sputum clinical analysis (36.8 %) and chest X-ray examination (59.2 %). Macrolides (56.2 %), aminopenicillins (54.7 %) and aminopenicillins with beta-lactamase inhibitors (39.3 %) were chosen most often between antibiotics classes. Internists chose mucoactive medicines (expectorants, cough suppressants, mucolytics, mucokinetics, etc.) most often (95.5%) between drugs to treat patients with AB.Conclusions. Among widespread physicians’ delusions it can be marked out 1) overestimation of significance of instrumental and (to the less extent) laboratory investigations for the diagnosis verification, excessive use of 2) mucoactive drugs with weak evidence of their benefits in patients with AB, and 3) aminopenicillins including combinations with beta-lactamase inhibitors, which are not active against key bacterial pathogens in AB as well. Herbal medicines are the drugs of choice in management of patients with AB and the first choice should be EPs 7630 (Umckalor), i.e. extract from the root of Pelargonium sidoides.