What is the difference between acute cough and acute bronchitis (inflammation of the bronchial tubes)?

From the Guidelines

Acute cough and bronchitis are distinct conditions, with acute cough being a symptom that can result from various causes, including viral upper respiratory infections, allergies, or irritants, and bronchitis being a specific inflammatory condition of the airways characterized by a persistent cough lasting 1-3 weeks, often with mucus production, chest discomfort, mild fever, and sometimes wheezing. The primary difference between the two conditions lies in their underlying causes, duration, and symptoms. An acute cough is a sudden onset of coughing that typically lasts less than three weeks, whereas bronchitis, particularly acute bronchitis, is an inflammation of the bronchial tubes that can last for several weeks 1.

Key Differences

• Acute cough is often self-limiting and resolves without specific treatment, whereas bronchitis requires more targeted approaches to manage symptoms, including rest, increased fluid intake, humidified air, and occasionally bronchodilators for wheezing 1.
• Acute cough may be a symptom of many conditions, including viral upper respiratory infections, allergies, or irritants, whereas bronchitis specifically involves inflammation of the airways.
• Treatment for acute cough typically focuses on symptom relief with over-the-counter medications, whereas bronchitis treatment requires a more comprehensive approach to manage symptoms and prevent complications.

Treatment Approaches

• For acute cough, treatment typically involves symptom relief with over-the-counter medications like dextromethorphan (15-30mg every 6-8 hours) for non-productive coughs or guaifenesin (200-400mg every 4 hours) for productive coughs.
• For bronchitis, treatment focuses on symptom management, including rest, increased fluid intake, humidified air, and occasionally bronchodilators for wheezing.
• Antibiotics are generally not recommended for either condition unless there's evidence of bacterial infection, as they are rarely effective for acute cough and can contribute to antimicrobial resistance 1.

Clinical Implications

• The distinction between acute cough and bronchitis is crucial, as bronchitis represents a specific inflammatory condition of the airways that requires targeted treatment to prevent complications and improve outcomes.
• Clinicians should carefully evaluate patients with acute cough to determine the underlying cause and develop an appropriate treatment plan, taking into account the patient's medical history, symptoms, and risk factors for complications.

From the Research

Definition and Duration

• Acute cough is defined as a cough present for 3 weeks or less 2
• Acute bronchitis is a type of lower respiratory tract infection that can cause acute cough 2

Causes

• Acute cough is most often caused by a viral infection of the upper or lower respiratory tract 2
• Acute bronchitis is often caused by a viral infection, but can also be caused by bacterial infections 3

Symptoms

• Acute cough can be accompanied by other symptoms such as runny nose, sore throat, and fatigue 2
• Acute bronchitis can cause symptoms such as cough, sputum production, and shortness of breath 4

Treatment

• Antibiotics are not indicated for most cases of acute cough or acute bronchitis 2, 3
• Symptomatic treatments such as antitussives and expectorants have limited evidence for efficacy in acute cough 4, 5, 3
• Honey has been studied as a potential treatment for acute cough, but its effectiveness is unclear 4

Diagnosis

• History-taking, exclusion of red flags, and physical examination are the basis of diagnostic evaluation for acute cough 3
• Laboratory tests, sputum diagnostics, and chest x-rays are not recommended for uncomplicated acute bronchitis 3

Management

• Evidence-based strategies to avoid antibiotic therapy, such as delayed prescribing and shared decision making, can be used in the management of acute cough 3
• COVID-19 should be considered in cases of acute respiratory symptoms 3
• Further diagnoses such as community-acquired pneumonia, influenza disease, and exacerbations of chronic respiratory diseases should be considered if specific symptoms or red flags occur 3