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Acute Exacerbation of Chronic Bronchitis : What Is the Clinical Significance of Pathogenic Bacteria in Sputum Cultures?

Chatrchai Watanakunakorn, MD, FCCP
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Youngstown, OH; Dr. Watanakunakorn is Director, Infectious Disease Section, Department of Internal Medicine, St. Elizabeth Health Center; and Professor of Internal Medicine, Northeastern Ohio Universities College of Medicine, Rootstown, OH.

Correspondence to: Chatrchai Watanakunakorn, MD, FCCP, St. Elizabeth Health Center, 1044 Belmont Ave, Youngstown, OH 44501-1790



Chest. 2000;118(6):1523-1525. doi:10.1378/chest.118.6.1523-a
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Acute exacerbation of chronic bronchitis (AECB) in patients with COPD is an important disease affecting millions of Americans. The use of antibiotics in such patients is controversial, as the etiology of AECB is complex, including inhalation of environmental irritants, discontinuation of medications, deviation from diet, viral infections, atypical bacterial infections, especially Chlamydia pneumoniae, and pyogenic bacterial infections.13 Although the use of antibiotics in patients with AECB has been reported to be beneficial,45 it is clear that not every episode of AECB needs antimicrobial therapy. Furthermore, injudicious use of antibiotics has led to increasing bacterial resistance, resulting in ineffectiveness of commonly used antibiotics.5

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