Acute bronchitis is generally self-limiting. Treatment is focused on the relief of symptoms. List supportive measures.
Recommend rest and adequate hydration.
Advise patients to avoid lung irritants (e.g., smoke, incense).
Reevaluate if any of the following:
Worsening typical symptoms (e.g., fever, dyspnea, cough)
New worrisome symptom (e.g., hemoptysis)
Persistent cough (lasting > 3 weeks)
Describe the symptomatic treatment.
Analgesics: NSAIDs or acetaminophen
Other symptom relievers: not routinely recommended
Antitussives
Expectorants
Bronchodilators
Steroids
Antihistamines
Describe the antibiotic treatment.
Generally not recommended
Only consider antibiotics in patients with suspected bacterial complications or an alternate diagnosis (e.g., pneumonia, pertussis, acute exacerbation of COPD).
What are complications?
Respiratory failure
Secondary bacterial infections (especially pneumonia)
Protracted bacterial bronchitis
Chronic bacterial infection that causes a productive cough
Clinical diagnosis requires all of the following:
Daily cough for > 4 weeks
Resolution within 2–4 weeks of antibiotic treatment
Absence of alternate diagnosis
Describe the prognosis.
Generally self-limiting
Risk factors for complications: advanced age, immunocompromise, preexisting lung conditions
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