Bronchitis medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chetan Lokhande, M.B.B.S [2]; Seyedmahdi Pahlavani, M.D. [3]; Nate Michalak, B.A.

Bronchitis Main page

Patient Information

Overview

Causes

Classification

Acute bronchitis
Chronic bronchitis

Differential Diagnosis

Overview

The majority of cases of bronchitis are caused by viruses and are self-limited. The treatment of bronchitis is primarily symptomatic and includes analgesics, decongestants, expectorants, and cough suppressants. The administration of antibiotics should be limited to cases in which a definitive pathogen is identified. Pharmacologic therapy for chronic bronchitis includes a combination of inhaled corticosteroids, bronchodilators ( e.g. Salbutamol), and inhaled anticholinergics (e.g. Ipratropium bromide).

Medical Therapy

Acute Bronchitis

Symptomatic

Treatment for acute bronchitis is primarily symptomatic. Even with no treatment, most cases of acute bronchitis resolve quickly.

Antimicrobial Agent

  • Approximately 5–10% of bronchitis cases are caused by a bacterial infection. Most cases of bronchitis are caused by a viral infection and are self-limiting, resolving in a few weeks.[1]
  • Antimicrobial agents are not recommended in most cases of acute bronchitis. Various randomized controlled trials and systematic reviews have shown a decrease in symptoms by just a fraction of day with use of antibiotics when compared with placebo. These results, though statistically significant, are not clinically significant (as improvement by only a fraction of day).
    • Antibiotic therapy did not help in a trial of patients who mainly had bronchitis. Approximately 15% had chronic obstructive lung disease and their results were not reported separately.[2]
  • Treatment with antibiotics can be administered in cases in which a definitive treatable pathogen is present.
    • Treatment of influenza virus with oseltamivir decreases the duration of symptoms by approximately 1 day and results in an earlier return to normal activity.
    • Treatment of patients with pertussis is indicated to limit transmission when the therapy is initiated during the first week of symptoms. However, the symptoms are not less severe even with administration of these antibiotics.
  • In cases of definitive diagnosis, anti-microbial agent may be used for for the following:

Other Therapy

  • Various other treatments, such as beta 2 agonists, mucolytic agents, anti-tussive agents, and corticosteroids have been used in different settings but no proven benefits have been shown in any of the clinical trials.

Chronic Bronchitis Treatment

Chronic bronchitis is treated symptomatically.

Smoking Cessation

To help the bronchial tree heal faster and limit progression of bronchitis, smokers should quit smoking.[3]

References

  1. Hueston WJ (1997). "Antibiotics: neither cost effective nor 'cough' effective". The Journal of Family Practice. 44 (3): 261–5. PMID 9071245. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  2. The American Academy of Family Physicians: Acute Bronchitis. January 2006. Accessed 20 March 2007.


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