Abstract

JUSTO, Iván; YEE SEURET, Suylleng; BALCINDES ACOSTA, Susana  and  ARNAEZ FERRER, Sandra B.. Pulmonary reinforcement: Its relation with the acute respiratory infection and the inadequate prescription of antibiotics. Rev Cubana Med Gen Integr [online]. 2004, vol.20, n.1. ISSN 0864-2125.

The aim of this paper was to determine whether the use of the pulmonary reinforcement term is associated or not to the inadequate prescription of antibiotics in acute respiratory infections (ARI) and to seek evidences supporting the use of this term. A self-administered questionnaire was applied to 300 physicians from the health assistance services at hospitals and polyclinics in Havana City. 200 of the participants were family physicians, whereas the other 100 were physicians from the health assistance area at hospitals. The following main variables were measured: association with ARI, apparent etiological cause, signs and symptoms, diagnostic methods, and the use of antibiotics in these patients. 140 (46.6 %) of the surveyed admitted having diagnosed PR. There was not a great difference with the 160 (53.3 %) that denied their use completely. Family physicians use it more (104; 34.3 %). Among those who use the PR term unequivocally, 129 (92.1 %) consider its relation with the ARI. As to etiology, 69 (49.4 %) consider the vital causes and 42 (29.9 %) the causes of bacterial origin. Cough was the most important symptom in patients that were diagnosed PR (94; 67.2). The chest X-ray was the most used method to make the diagnosis (ll8; 84.3 %). The antibiotics were the most prescribed group of drugs (91; 65.0 %), and penicillins the most widely used antibiotic group (51; 36.4 %). The PR is commonly diagnosed by physicians at both health care levels, in spite of the fact that there is no enough evidence in medical literature and of the lack of consensus regarding its meaning. Even though, most of the physicians that use this term consider PR as a useful diagnosis in the management of patients with ARI and a high number of participants prescribe antibiotics in this case.

Keywords : Pulmonary reinforcement; ARI; acute bronchitis; antibiotics in ARI.