Chronic bronchitis is the most common condition in the category of chronic
obstructive pulmonary disease(COPD). The term COPD refers to any condition
that causes difficulty in breathing as a result of constant blocking of the
airways. Bronchitis occurs when the bronchial tubes become partly clogged
with large amounts of mucus and when they become narrowed because of
inflammation and swelling. These symptoms typically result in continual
coughing, and when they have been present for more than three months in
each of two consecutive years, patients are said to have chronic bronchitis.
 When breathing suddenly becomes more difficult for these patients, they
may be experiencing an acute exacerbation of chronic bronchitis (AECB).
During an acute exacerbation, breathing is labored because of further
narrowing of the airways and secretion of large amounts of mucus that is
often thicker than usual.
 These attacks are caused by a variety of factors, including allergens, toxins,
and viral or bacterial infections. Smoking is often a cause of an episode, and
more than 61% of patients with AECBs have the co-existing illness Tobacco
Use Disorder(ICD-9 code 305.1).
 More than 600,000 hospitalizations take place each year as a result of AECBs
(ICD- code 491.21), and that number is increasing, according to data from
MediMedia`s Hospital Diagnosis and Therapy Audit. The demographics of this
patient population have remained relatively stable over the past few
years, but treatment patterns have changed somewhat.
 Quinolones are used more often(in 50% of patients) than any other class of
drugs prescribed for the treatment of AECB; next are the cephalosporins(in
42%) and the extendedspectrum macrolides(in 28%). From 2000 to 2002,
levofloxacin (Levaquin™, Ortho-McNeil) was the most commonly prescribed
quinolone, but in 2003 it began losing some ground to gatifloxacin(Tequin?,
Bristol-Myers Squibb). However, ceftriaxone sodium(Rocephin?, Roche) (not
shown in the figure) surpassed levofloxacin as the top agent prescribed for
this indication(29% vs. 21%) in the first quarter of 2003.


■ 기사 요지 

 Medimedia USA 발간 `P&T(Pharmacy & Therapeutics)`에 게재된 내용으로 만성기관
지염의 급성악화를 다루고 있다.
 만성기관지염은 만성폐쇄성폐질환(COPD)으로 분류되는 가장 일반적인 질병이다. 미국에
서는 매년 60만명 이상의 환자가 만성기관지염의 급성악화(AECB)로 입원하는 것으로 확인
됐다.
 반면, 2000~2003년까지 미국내 AECB 사망률은 5.3%에서 5.4%로 큰 변화를 보이지
않았다. AECB 치료에는 퀴놀론계 항생제가 가장 많이 사용되고 있으며, 세팔로스포린계와 마
크로라이드 광범위항생제 등이 뒤를 잇고 있다.
정리·이상돈 기자
sdlee@kimsonline.co.kr
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