From the Guidelines
Treating bronchitis in children typically involves supportive care at home, with a focus on relieving symptoms and preventing complications, as most cases are viral and will resolve within 1-2 weeks without antibiotics 1. The goal of treatment is to reduce morbidity, mortality, and improve quality of life. To achieve this, the following steps can be taken:
- Ensure the child gets plenty of rest and fluids to stay hydrated
- For fever or discomfort, give acetaminophen (Tylenol) at 10-15 mg/kg every 4-6 hours or ibuprofen (Motrin) at 5-10 mg/kg every 6-8 hours, following age-appropriate dosing on the package
- Use a cool-mist humidifier in the child's room to help ease breathing by loosening mucus
- For children over 1 year, honey (1/2 to 1 teaspoon) can soothe cough symptoms, but never give honey to infants under 12 months due to botulism risk Some key points to consider:
- Most cases of bronchitis in children are viral and will resolve without antibiotics 1
- Antibiotics are rarely needed unless there's a confirmed bacterial infection 1
- Cough suppressants and decongestants are generally not recommended for young children due to potential side effects and limited evidence of benefit
- Seek medical attention if the child has difficulty breathing, persistent high fever, worsening symptoms after initial improvement, or if symptoms last longer than 3 weeks 1
From the Research
Treatment Options for Bronchitis in Children
- The management of acute bronchitis in children involves a range of issues, including epidemiology, pathogenesis, and treatment 2.
- Treatment of respiratory syncytial virus bronchiolitis, a common cause of bronchitis in children, rests primarily on supportive care with oxygen and fluid management 3.
- Other therapies commonly used for bronchiolitis include bronchodilators, corticosteroids, and ribavirin, although their effectiveness may vary 3.
Antibiotic Use in Bronchitis Treatment
- Antibiotics are often prescribed for acute bronchitis, but their effectiveness is limited, with only a half-day reduction in duration of cough 4.
- Expert commentary suggests that clinicians should be aware of the marginal effectiveness of antibiotic therapy and consider alternative strategies to reduce unnecessary utilization 4.
- A study comparing azithromycin and co-amoxiclav in the treatment of acute tracheobronchitis and acute infectious exacerbations of chronic bronchitis in adults found that azithromycin produced a significantly higher cure rate 5.
Specific Antibiotic Treatments
- A multicentre, three-arm, double-blind, randomised placebo-controlled trial found that oral amoxicillin-clavulanate was beneficial in achieving symptom resolution of non-severe exacerbations of bronchiectasis in children 6.
- The study also found that azithromycin was effective, although to a lesser extent than amoxicillin-clavulanate, with a relative risk for resolution by day 14 of 1.41 (95% CI 1.01-1.97, p=0.042) 6.
Supportive Care and Symptom Management
- Supportive care with oxygen and fluid management is a crucial component of bronchiolitis treatment 3.
- Other therapies, such as bronchodilators and corticosteroids, may be used to relieve airway obstruction, especially in severe cases 3.
- Symptom management, including control of cough and fever, is also an important aspect of bronchitis treatment in children.