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Disease prevention, early detection and effective management.

9.3 Bronchitis

Table of Contents

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.

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