Bronchitis Treatment Guidelines
Introduction to Bronchitis Management
- The American College of Chest Physicians recommends avoidance of respiratory irritants as the cornerstone of therapy for chronic bronchitis, with 90% of patients experiencing resolution of cough after smoking cessation 2, 3
- For acute bronchitis, antibiotics should not be prescribed unless pneumonia is suspected, as viruses are responsible for more than 90% of infections 1
Acute Bronchitis Treatment
- Short-acting β-agonists like albuterol may be beneficial in reducing cough duration and severity in patients with evidence of bronchial hyperresponsiveness 1
- Ipratropium bromide may improve cough in some patients with acute bronchitis 1
- Dextromethorphan or codeine are recommended for short-term symptomatic relief of bothersome cough 1
Chronic Bronchitis Treatment
- Short-acting β-agonists should be used to control bronchospasm and may reduce chronic cough 2, 3, 4
- Ipratropium bromide should be offered to improve cough 2, 3, 4
- Long-acting β-agonists combined with inhaled corticosteroids should be offered to control chronic cough 2, 3
- Inhaled corticosteroids should be offered to patients with chronic bronchitis and severe airflow obstruction or those with frequent exacerbations 2, 3
Acute Exacerbations of Chronic Bronchitis
- Short-acting β-agonists or anticholinergic bronchodilators should be administered during acute exacerbations 2, 3, 4
- Antibiotics are recommended for acute exacerbations of chronic bronchitis, particularly for patients with severe exacerbations and those with more severe airflow obstruction at baseline 2, 3
- A short course (10-15 days) of systemic corticosteroids is effective for acute exacerbations 4