From the Guidelines
Acute bronchitis treatment should focus on symptom relief without the use of antibiotics, unless there is clear evidence of bacterial infection or high risk for complications, as stated in the 2020 Chest expert panel report 1. The primary goal of treatment is to alleviate symptoms while the infection resolves naturally.
- Rest and increased fluid intake can help manage symptoms.
- Over-the-counter medications like acetaminophen (Tylenol) 325-650mg every 4-6 hours or ibuprofen (Advil, Motrin) 200-400mg every 4-6 hours can help manage fever and pain.
- For cough relief, dextromethorphan (Robitussin DM) 10-20mg every 4 hours or guaifenesin (Mucinex) 600-1200mg every 12 hours can be effective. A humidifier or steam inhalation may loosen mucus and ease breathing. According to the American College of Physicians and the Centers for Disease Control and Prevention, antibiotics are generally not recommended for acute bronchitis since it's typically viral, unless there's clear evidence of bacterial infection or high risk for complications, as noted in the 2016 Annals of Internal Medicine study 1. Most cases improve within 1-2 weeks without specific treatment. If symptoms worsen, persist beyond 3 weeks, or include high fever, difficulty breathing, or bloody mucus, medical attention should be sought immediately. Smoking cessation is crucial as it worsens symptoms and delays recovery by irritating the bronchial tubes and impairing the lungs' natural cleaning mechanisms. It's essential to distinguish acute bronchitis from pneumonia, as pneumonia requires different management, and the absence of certain clinical criteria, such as tachycardia, tachypnea, fever, and abnormal findings on a chest examination, can help rule out pneumonia in healthy immunocompetent adults younger than 70 years, as suggested in the 2016 Annals of Internal Medicine study 1.
From the FDA Drug Label
Helps loosen phlegm (mucus) and thin bronchial secretions to make coughs more productive. temporarily relieves • cough due to minor throat and bronchial irritation as may occur with the common cold or inhaled irritants The treatment for acute bronchitis may include:
- Guaifenesin to help loosen phlegm and thin bronchial secretions, making coughs more productive 2
- Dextromethorphan to temporarily relieve cough due to minor throat and bronchial irritation 3
From the Research
Acute Bronchitis Treatment Overview
- Acute bronchitis is typically caused by viruses, with more than 90 percent of cases attributed to viral infections 4
- The condition is characterized by inflammation of the large airways within the lung, accompanied by a cough lasting from 1 to 3 weeks 5
- Symptoms of bronchitis typically last about two to three weeks, and the presence or absence of colored sputum does not reliably differentiate between bacterial and viral lower respiratory tract infections 4, 6
Treatment Options
- Antibiotics are generally not indicated for bronchitis, except in cases where pertussis is suspected or the patient is at increased risk of developing pneumonia 4, 6
- Symptomatic treatment of cough is primarily required for patients, and may include nonpharmacological and pharmacological options such as antitussive agents, protussive agents, and beta-2-agonists 5
- The supplement pelargonium may help reduce symptom severity in adults 4
- Guaifenesin, a mucoactive drug, can be used to loosen mucus in the airways and make coughs more productive, and is considered a safe and effective expectorant for the treatment of mucus-related symptoms in acute upper respiratory tract infections and stable chronic bronchitis 7
Management Strategies
- Evaluation and treatment of bronchitis include ruling out secondary causes for cough, such as pneumonia, and educating patients about the natural course of the disease 6
- Strategies to reduce inappropriate antibiotic use include delayed prescriptions, patient education, and calling the infection a chest cold 6
- Effective communication strategies are necessary to provide the safest therapies available while maintaining patient satisfaction, as patient expectations for antibiotics and therapies for symptom management often differ from evidence-based recommendations 4