Objective: To determine the prevalence of viruses and atypical pathogens as causes of acute severe exacerbations of chronic bronchitis.
Design: Retrospective.
Setting: University Hospital Utrecht, the Netherlands.
Methods: In 4 studies with 305 patients with severe type-1 exacerbations (increase of dyspnoea, of sputum volume and of sputum purulence) serological tests for viral and atypical pathogens were performed.
Results: Positive serology for viral infections was seen in 18 (5.9%) patients and for the atypical pathogens in 12 (3.9%) patients.
Conclusions: Since viruses and atypical pathogens are the cause of the exacerbation in only few cases, clinical signs can be used in decision-making whether or not to prescribe antibiotics in acute exacerbations of chronic bronchitis.