From the Guidelines
The current treatment protocol for viral bronchitis is primarily supportive care, focusing on symptom management and avoiding unnecessary antibiotic use, as recommended by the American College of Physicians and the Centers for Disease Control and Prevention 1. The treatment approach includes rest, adequate hydration, and over-the-counter medications to manage symptoms such as cough, fever, and discomfort.
- Antipyretics like acetaminophen (325-650 mg every 4-6 hours, not exceeding 3000 mg daily) or ibuprofen (400-600 mg every 6-8 hours with food) can reduce fever and relieve discomfort.
- Cough suppressants containing dextromethorphan (15-30 mg every 6-8 hours) may help control persistent cough, particularly at night.
- Expectorants like guaifenesin (200-400 mg every 4 hours) can thin mucus and facilitate clearance.
- Humidified air and adequate fluid intake help loosen secretions. Most cases resolve within 1-3 weeks without specific antiviral therapy.
On auscultation, characteristic sounds of viral bronchitis include:
- Diffuse rhonchi (low-pitched, continuous rumbling sounds during expiration)
- Scattered wheezes (high-pitched whistling sounds caused by narrowed airways)
- Occasional coarse crackles (discontinuous bubbling sounds) These sounds reflect inflammation of the bronchial airways and increased mucus production, as noted in guidelines for managing acute bronchitis 1. It is essential to distinguish acute bronchitis from pneumonia, considering clinical criteria such as tachycardia, tachypnea, fever, and abnormal findings on chest examination 1. The decision not to use antibiotics should be addressed individually, explaining the rationale to patients who may expect antibiotic treatment based on previous experiences 1. In select cases, such as confirmed or probable whooping cough, macrolide antibiotics may be indicated, along with isolation to prevent disease spread 1.
From the Research
Current Treatment Protocol for Viral Bronchitis
- The current treatment protocol for viral bronchitis primarily involves supportive care, including oxygen and fluid management 2.
- Other therapies that may be used include bronchodilators, corticosteroids, and ribavirin, although their use is considered on a case-by-case basis 2.
- Antibiotics are generally not indicated for viral bronchitis, unless there is a suspicion of pertussis or the patient is at increased risk of developing pneumonia 3, 4.
- Symptomatic treatments, such as antitussives, anticholinergics, and honey, have been shown to be ineffective in reducing cough in adults with uncomplicated acute bronchitis 5.
Characteristic Sounds on Auscultation
- There is limited information available on the characteristic sounds of viral bronchitis on auscultation in the provided studies.
- However, it is known that acute bronchitis is characterized by cough due to acute inflammation of the trachea and large airways without evidence of pneumonia 4.
- The presence of abnormal lung sounds, such as wheezing or crackles, may indicate the presence of pneumonia or other complications, and would require further evaluation and treatment 4.