Cough

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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.

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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.

Please visit us for a treatment plan.

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