9.3.1 Acute Bronchitis
It is a self-limited inflammation of the bronchi due to upper airway infection. Acute bronchitis is one of the most common conditions associated with antibiotic misuse. This respiratory condition is generally caused by a virus. Pertussis is the only indication for antibacterial agents in the treatment of acute bronchitis.
It is also known as a chest cold, is short-term inflammation of the bronchi (large and medium-sized airways) of the lungs.
Diagnostic Criteria
- Patients with acute bronchitis present with a cough lasting more than five days (typically one to three weeks), which may be associated with sputum production.
- Acute bronchitis should be distinguished from chronic bronchitis (see below), it is not a form of COPD.
Symptomatic Treatment
- With non-steroidal anti-inflammatory drugs: paracetamol, aspirin
- Cough suppressant syrups
- There is NO benefit from antibiotic use
9.3.2 Chronic Bronchitis
It defined by a chronic productive cough for three months in each of two successive years in a patient in whom other causes of chronic cough have been excluded. Patients may get secondary bacterial infection with development of fever and production of thick smelly sputum.
Non-Pharmacological Treatment
- Stop smoking and/or remove from hazardous environment
- Prompt treatment of infective exacerbations
- Antibiotics as above in case of secondary bacterial infection
- Controlled oxygen therapy
- Physiotherapy
- Bronchodilator may give some benefit
Pharmacological Treatment
A: Inhaler Salbutamol (PO) 100 µg two puff 6 hourly
OR
A: Salbutamol (PO) 4mg 8 hourly
OR
D: Ipratropium bromide aerosol 20–80mg, 6–8 hourly
Trial of steroids if there is possibility of reversible airways obstructions A: Prednisolone (PO) 20mg once daily for 5 days
Note: Patient should be given salbutamol inhaler but when not available consider salbutamol tablets.