Acute bronchitis is a common clinical condition characterized by cough, with or without sputum production, which lasts for at least five days. It is typically self-limited, resolving within one to three weeks. By definition, patients with acute bronchitis do not have underlying chronic obstructive pulmonary disease (COPD).

●The majority of cases of acute bronchitis are caused by infection with respiratory viruses, such as rhinoviruses, coronaviruses, influenza viruses, and respiratory syncytial virus. Bacteria are rare causes, accounting for <10 percent of cases. The most common bacterial causes are Bordetella pertussis, Mycoplasma pneumoniae, and Chlamydia pneumoniae. 

●For most patients, the diagnosis can be made based on history and physical examination, and additional testing is not needed.

●Chest radiographs are indicated when acute bronchitis cannot be clinically distinguished from pneumonia. Reasonable indications for suspecting pneumonia and obtaining imaging include abnormal vital signs (pulse >100/minute, respiratory rate >24 breaths/minute, temperature >38°C [100.4°F], or oxygen saturation <95 percent), signs of consolidation on lung examination (rales, egophony, or tactile fremitus), and mental status changes in patients >75 years old.

●Treatment should focus on patient education and supportive care. Remember most of the times, cough does not need antibiotics. 

●For patients with acute bronchitis who are bothered by cough, we offer nonpharmacologic options for cough relief such as throat lozenges, hot tea, and/or smoking cessation or avoidance of second hand smoke.

●For patients who desire medication for cough relief, we suggest offering over-the-counter (OTC) medications, such as dextromethorphan or guaifenesin rather than other medications. We reserve use of inhaled beta-agonists, such as albuterol, for patients with wheezing and underlying pulmonary disease.

●For patients with clinically diagnosed acute bronchitis, Dr.Paul recommends NOT treating with empiric antibiotic therapy. Acute bronchitis is a leading cause of antibiotic overuse; reducing inappropriate antibiotic use for this indication is global healthcare priority.

If you are smoking, please stop it for the sake of your health and of others around you.

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