From the Guidelines
Symbicort should not be used for acute bronchitis of viral etiology. The most recent and highest quality study, published in 2020 in the journal Chest 1, suggests that inhaled corticosteroids, such as budesonide, should not be routinely prescribed for immunocompetent adult outpatients with cough due to acute bronchitis. This is because the underlying viral infection will not be addressed by Symbicort, and corticosteroids might suppress the immune system when it's needed to fight the infection.
Key Points to Consider
- Viral bronchitis is an infection of the airways caused by viruses, and it generally resolves on its own with supportive care like rest, hydration, and over-the-counter medications to manage symptoms.
- Symbicort, which contains budesonide (a corticosteroid) and formoterol (a long-acting beta-agonist), is primarily designed to treat chronic respiratory conditions like asthma and COPD by reducing inflammation and opening airways.
- Treatment for viral bronchitis usually focuses on symptom relief with medications like acetaminophen for fever and pain, cough suppressants if needed, and plenty of fluids.
- The 2020 Chest expert panel report 1 emphasizes the importance of clinically and radiographically excluding other differential explanations for the presentation, and suggests that targeted investigations, such as chest x-ray or sputum for microbial culture, may be considered if the acute bronchitis persists or worsens.
Evidence-Based Recommendation
Based on the evidence from the 2020 Chest expert panel report 1 and other studies 1, Symbicort is not recommended for viral bronchitis. Instead, treatment should focus on symptom relief and supportive care, with consideration for targeted investigations and antibiotic therapy if a complicating bacterial infection is thought likely. It's best to consult with a healthcare provider who can determine the appropriate treatment based on whether the condition is viral or bacterial and recommend medications specifically suited to the situation.
From the Research
Symbicort for Acute Bronchitis of Viral Etiology
- The provided studies do not directly address the use of Symbicort (budesonide and formoterol) for acute bronchitis of viral etiology 2, 3, 4, 5, 6.
- However, the studies discuss the use of glucocorticoids and bronchodilators in the management of acute viral bronchiolitis and asthma.
- According to 2, bronchodilators should not be routinely used in the management of acute viral bronchiolitis, but may be effective in some patients.
- The study 3 found that glucocorticoids did not significantly reduce outpatient admissions or length of hospitalization in children with acute viral bronchiolitis.
- Symbicort is approved for the maintenance management of stable COPD and persistent asthma, but its use in acute bronchitis of viral etiology is not established 5, 6.
- There is no clear evidence to support the use of Symbicort for acute bronchitis of viral etiology, and its use in this context would be off-label.
Key Findings
- The majority of infants and children with bronchiolitis do not require specific measures, and supportive care is the cornerstone of current treatment 2.
- Glucocorticoids and bronchodilators may be effective in some patients with acute viral bronchiolitis, but their use is not routinely recommended 2, 3.
- Symbicort is a combination of an inhaled corticosteroid and a long-acting beta2-adrenergic agonist, and its use in asthma and COPD is well established 4, 5, 6.