From the Guidelines
Antibiotics are not recommended for acute bronchitis unless pneumonia is suspected or there are clinical signs of a bacterial infection.
Recommended Antibiotics
When antibiotics are necessary, the choice should be based on effective treatment of the most commonly reported bacterial pathogens, which include:
- Haemophilus influenzae
- Streptococcus pneumoniae
- Moraxella catarrhalis The recommended antibiotics may include:
- Aminopenicillin with clavulanic acid
- Macrolide
- Tetracycline 1
Duration of Antibiotic Treatment
The duration of antibiotic treatment for acute uncomplicated bronchitis with clinical signs of a bacterial infection should be limited to 5 days 1.
Important Considerations
It is essential to note that acute bronchitis is typically a self-limited infection of the large airways, usually caused by a virus, and routine treatment with antibiotics is not justified 1. Clinicians should not perform testing or initiate antibiotic therapy in patients with bronchitis unless pneumonia is suspected 1.
From the Research
Recommended Antibiotics for Acute Bronchitis
The following antibiotics have been studied for the treatment of acute bronchitis:
Effectiveness of Antibiotics
Studies have shown that antibiotics may have a modest beneficial effect in the treatment of acute bronchitis, including:
- Decreasing the duration of cough and sputum production by approximately one-half day 2
- Reducing the likelihood of feeling unwell at follow-up visits 3
- Shortening the duration of productive cough 4 However, the benefits of antibiotics must be weighed against the risk of side effects and the societal cost of increasing antibiotic resistance 2, 5.
Prescribing Practices
Antibiotics are often over-prescribed for acute bronchitis, with broad-spectrum antibiotics making up the majority of prescriptions 6. Factors associated with higher antibiotic prescribing rates include: