What is the treatment for bronchitis?

From the Guidelines

Bronchitis treatment typically involves managing symptoms while the body fights the infection, with a focus on avoiding respiratory irritants and using pharmacologic therapy as needed. For acute bronchitis, rest, increased fluid intake, and over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil) at standard doses (acetaminophen 325-650mg every 4-6 hours, ibuprofen 200-400mg every 6-8 hours) can help reduce fever and discomfort, as suggested by 1. A humidifier or steam inhalation can loosen mucus. Over-the-counter cough suppressants containing dextromethorphan may help with sleep if coughing is disruptive, while expectorants with guaifenesin can help thin mucus.

Key Considerations

• Antibiotics are generally not recommended for acute bronchitis as it's usually viral, unless bacterial infection is confirmed, as noted in 1.
• For chronic bronchitis, bronchodilators like albuterol (2 puffs every 4-6 hours as needed), inhaled corticosteroids, and sometimes oral steroids may be prescribed, as recommended by 1 and 1.
• Smoking cessation is crucial as continued smoking worsens bronchitis and delays recovery, with evidence from 1 showing that 90% of patients will have resolution of their cough after smoking cessation.
• Pulmonary rehabilitation may benefit those with chronic bronchitis.

Treatment Approach

• For stable patients with chronic bronchitis, therapy with short-acting β-agonists, ipratropium bromide, and oral theophylline may improve cough, as suggested by 1 and 1.
• For acute exacerbations of chronic bronchitis, inhaled bronchodilators, oral antibiotics, and oral corticosteroids (or in severe cases IV corticosteroids) are useful, but their effects on cough have not been systematically evaluated, as noted in 1 and 1.
• Central cough suppressants such as codeine and dextromethorphan are recommended for short-term symptomatic relief of coughing, as recommended by 1.

Monitoring and Follow-up

• Most acute bronchitis cases resolve within 1-2 weeks, but the cough may persist for several weeks.
• Seek medical attention if symptoms worsen, breathing becomes difficult, or fever persists beyond 3 days.

From the FDA Drug Label

1.2 Maintenance Treatment of Chronic Obstructive Pulmonary Disease Wixela Inhub® 250/50 is indicated for the twice-daily maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.

The treatment for chronic bronchitis is Wixela Inhub® 250/50, which is indicated for the twice-daily maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema 2.

• The recommended dosage is 1 inhalation of Wixela Inhub® 250/50 twice daily, approximately 12 hours apart.
• Tiotropium is also used for the maintenance treatment of COPD, including chronic bronchitis and/or emphysema, as stated in the STIOLTO RESPIMAT label 3.
• The recommended dosage of STIOLTO RESPIMAT is two inhalations once-daily at the same time of the day.

From the Research

Treatment Options for Bronchitis

The treatment for bronchitis depends on the type and cause of the condition.

• For acute bronchitis, treatment is usually symptomatic, with a focus on relieving symptoms such as cough and sore throat 4.
• Antitussive agents may be used to treat a troublesome cough, and secretolytic or mucolytic substances may be used to help clear bronchial mucus 4.
• For chronic bronchitis, treatment primarily involves eliminating the underlying cause, such as quitting smoking 4.
• Antibiotics may be used to treat bacterial infections, such as those that occur in acute exacerbations of chronic bronchitis 4, 5.
• Broad-spectrum antibiotics may be appropriate in selected patients with acute bronchitis 6.

Use of Antibiotics

• Antibiotics are generally not indicated for acute bronchitis, as most cases are caused by viruses 7.
• However, antibiotics may be used if pertussis is suspected, or if the patient is at increased risk of developing pneumonia, such as those over 65 years old 7.
• In cases of acute bacterial exacerbations of chronic bronchitis, antibiotics such as ampicillin or quinolones may be effective 5.

Symptomatic Treatment

• Symptomatic treatment for acute bronchitis may include over-the-counter medications to relieve cough and other symptoms 7.
• However, the effectiveness of these treatments is limited, and the US Food and Drug Administration recommends against using cough and cold preparations in children under 6 years old 7.
• The supplement pelargonium may help reduce symptom severity in adults with acute bronchitis 7.