Treatment of Bronchitis

Acute Bronchitis Management

The American College of Physicians recommends that routine antibiotic treatment of uncomplicated acute bronchitis is NOT recommended, regardless of cough duration 2, 3, 1
The European Respiratory Society suggests that antibiotics should be reserved only for specific circumstances, such as suspected pertussis infection, high-risk populations, or patients with cardiac failure 1
Short-acting β-agonists, like albuterol, may be beneficial for reducing cough duration and severity in patients with evidence of bronchial hyperresponsiveness, according to the American College of Chest Physicians 1
Antitussives containing dextromethorphan or codeine are recommended for short-term symptomatic relief of bothersome cough by the American Academy of Family Physicians 4, 1
Patient satisfaction depends more on physician-patient communication than on receiving antibiotics, as stated by the American Medical Association 4, 3

The Global Initiative for Chronic Obstructive Lung Disease recommends that short-acting β-agonists should be used to control bronchospasm and may reduce chronic cough 1
The European Respiratory Society suggests that ipratropium bromide should be offered to improve cough symptoms 1
Inhaled corticosteroids should be offered to patients with chronic bronchitis and FEV1 <50% predicted or those with frequent exacerbations, according to the American Thoracic Society 1

The American College of Chest Physicians defines acute bronchitis as self-limited inflammation of the large airways with cough lasting up to 6 weeks 1
The European Respiratory Society defines chronic bronchitis as cough with sputum production occurring on most days for at least 3 months of the year and for at least 2 consecutive years 1
Pneumonia should be ruled out before diagnosing uncomplicated bronchitis by assessing for tachycardia, tachypnea, fever, and abnormal chest examination findings, as recommended by the American College of Emergency Physicians 3, 1

The European Respiratory Society recommends that in patients with obstructive chronic bronchitis with chronic respiratory insufficiency, immediate antibiotic therapy is recommended for exacerbations 5
For exacerbations of simple chronic bronchitis, antibiotic therapy is only recommended if fever persists for more than 3 days, according to the European Respiratory Society 5
For exacerbations of chronic obstructive bronchitis, immediate antibiotic therapy is only recommended if at least two of the three Anthonisen criteria are present, as stated by the European Respiratory Society 5