What is the typical treatment for acute bronchitis?

From the Guidelines

The typical treatment for acute bronchitis focuses on symptom management since most cases are viral and resolve on their own within 1-3 weeks. According to the most recent and highest quality study 1, routine antibiotic treatment of uncomplicated acute bronchitis is not recommended, regardless of the duration of cough. The study suggests that patients can benefit from analgesics, antipyretics, beta-agonist inhalers, antitussives, or vaporizers to manage symptoms.

Some key points to consider in the management of acute bronchitis include:

• Rest and increased fluid intake to 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 to manage fever and pain
• Cough relief with dextromethorphan (found in Robitussin DM) 10-20mg every 4 hours or guaifenesin (Mucinex) 200-400mg every 4 hours
• A humidifier or steam inhalation to help loosen mucus
• Inhaled bronchodilators such as albuterol (2 puffs every 4-6 hours as needed) for patients with underlying conditions like asthma or COPD

It's essential to note that antibiotics are generally not recommended for acute bronchitis unless there's clear evidence of a bacterial infection, as most cases are viral 1. If symptoms worsen, persist beyond three weeks, or if you develop high fever, shortness of breath, or bloody mucus, seek medical attention immediately as these could indicate a more serious condition like pneumonia.

From the FDA Drug Label

Adult PatientsAcute Bacterial Exacerbations of Chronic Obstructive Pulmonary Disease In a randomized, double-blind controlled clinical trial of acute exacerbation of chronic bronchitis (AECB), azithromycin (500 mg once daily for 3 days) was compared with clarithromycin (500 mg twice daily for 10 days).

The typical treatment for acute bronchitis is not explicitly stated in the provided text, but it can be inferred that azithromycin is used to treat acute bacterial exacerbations of chronic bronchitis.

• The clinical cure rate for 3 days of azithromycin was 85% compared to 82% for 10 days of clarithromycin.
• The most common side effects were diarrhea, nausea, and abdominal pain with comparable incidence rates for each symptom of 5 to 9% between the two treatment arms 2.

From the Research

Typical Treatment for Acute Bronchitis

The typical treatment for acute bronchitis is focused on relieving symptoms, as the condition is usually caused by a virus and is self-limiting.

• The majority of cases, over 90%, are caused by viruses 3, 4, 5.
• Antibiotics are generally not indicated for bronchitis, except in specific cases such as suspected pertussis or in patients at increased risk of developing pneumonia 3, 6, 5.
• Symptom relief and patient education regarding the expected duration of cough (2-3 weeks) are recommended for the management of acute bronchitis 6.
• Strategies shown to decrease antibiotic prescribing include delayed antibiotic prescriptions and describing acute bronchitis as a chest cold 6.
• Other therapies targeted to control symptoms have demonstrated a marginal or no effect, and expert commentary suggests clinicians should be aware of the marginal effectiveness of antibiotic therapy 5.

Management of Acute Bronchitis Symptoms

• The U.S. Food and Drug Administration recommends against using cough and cold preparations in children younger than six years 3.
• The supplement pelargonium may help reduce symptom severity in adults 3.
• Bronchodilators such as albuterol have been found to relieve some symptoms of acute bronchitis in a few small studies 4.
• Supportive measures, such as minimal handling, securing adequate oxygenation and hydration, are generally recommended for acute bronchiolitis 7.
• Short-acting beta-2 agonists are the first choice for the treatment of wheezy bronchitis, and inhaled corticosteroids may be tried to control symptoms in children with frequently recurring and/or severe episodes of wheezy bronchitis 7.