From the Guidelines
The most effective treatment for chronic bronchitis involves a combination of pharmacological and non-pharmacological interventions, with the primary goal of improving symptoms, reducing exacerbations, and enhancing quality of life.
Treatment Approach
The treatment approach for chronic bronchitis should be individualized, taking into account the severity of symptoms, the presence of comorbidities, and the patient's response to previous treatments.
- For stable patients with chronic bronchitis, therapy with short-acting β-agonists should be used to control bronchospasm and relieve dyspnea; in some patients, it may also reduce chronic cough 1.
- Additionally, therapy with ipratropium bromide should be offered to improve cough 1, and treatment with theophylline should be considered to control chronic cough; careful monitoring for complications is necessary 1.
- For patients with an acute exacerbation of chronic bronchitis, therapy with short-acting β-agonists or anticholinergic bronchodilators should be administered during the acute exacerbation 1.
- It is also essential to avoid exposure to respiratory irritants, such as personal tobacco use, passive smoke exposure, and workplace hazards, as this can significantly improve or eliminate the cough of chronic bronchitis 1.
Non-Pharmacological Interventions
Non-pharmacological interventions, such as smoking cessation and avoidance of respiratory irritants, play a crucial role in the management of chronic bronchitis.
- Ninety percent of patients will have resolution of their cough after smoking cessation 1.
- Smoke-free workplace and public place laws should be enacted in all communities to reduce exposure to respiratory irritants 1.
Pharmacological Interventions
Pharmacological interventions should be tailored to the individual patient's needs and response to treatment.
- Inhaled corticosteroid therapy should be offered to stable patients with chronic bronchitis and an FEV1 of < 50% predicted or for those patients with frequent exacerbations of chronic bronchitis 1.
- Long-acting β-agonists coupled with an inhaled corticosteroid should be offered to control chronic cough 1.
- Antibiotics should be used in patients with acute exacerbations of chronic bronchitis, particularly those with severe exacerbations and those with more severe airflow obstruction at baseline 1.
From the FDA Drug Label
Ciprofloxacin Tablets USP, 250 mg, 500 mg and 750 mg is indicated for the treatment of infections caused by susceptible strains of the designated microorganisms in the conditions and patient populations listed below.
The FDA drug label does not answer the question.
From the Research
Treatment of Beckwith-Wiedemann Syndrome (BWS)
- The treatment of BWS is focused on managing its various clinical features, including overgrowth, abdominal wall defects, macroglossia, neonatal hypoglycemia, and predisposition to embryonal tumors 2.
- Genetic testing is essential for diagnosing BWS, and recommended first-line testing assesses DNA methylation and copy number variation of the BWS region 2.
- Identifying the BWS molecular subtype is valuable for coordinating patient care because of the (epi)genotype-phenotype correlations, including different risks and types of embryonal tumors 2.
Treatment of Bacterial Infections
- Antibiotic treatment is commonly used to treat bacterial infections, but there is increasing recognition of the link between antibiotic overuse and antimicrobial resistance 3, 4.
- Recent studies have demonstrated that shorter courses of antibiotic therapy can be effective for many common infections, including community-acquired pneumonia, intraabdominal sepsis, and gram-negative bacteraemia 3.
- The choice of antibiotic and treatment duration should be guided by the specific infection and patient factors, and narrower antibiotics may be sufficient in some cases 4.
Treatment of Specific Infections
- Q fever, caused by Coxiella burnetii, is traditionally treated with tetracycline antibiotics, such as doxycycline, but alternative antibiotics like levofloxacin may be effective and better tolerated 5.
- Vibrio vulnificus foodborne septicemia can be effectively treated with combination therapy, including ceftriaxone, cefepime, doxycycline, and ciprofloxacin 6.