From the Guidelines
Management of acute bronchitis with confirmed Influenza A virus infection involves symptomatic relief and antiviral therapy.
Antiviral Treatment
Oseltamivir (Tamiflu) 75mg orally twice daily for 5 days or Zanamivir (Relenza) 10mg inhaled twice daily for 5 days is recommended for antiviral treatment 1.
Symptomatic Relief
Additionally, cough suppression with dextromethorphan 15-30mg orally every 4-6 hours as needed and pain management with acetaminophen 650-1000mg orally every 4-6 hours as needed may be considered.
Antibiotic Use
Antibiotics are not recommended for treatment of acute bronchitis unless there is evidence of a secondary bacterial infection 1.
- The decision not to use an antibiotic should be addressed individually and explanations should be offered to the patient 1.
- Routine antibiotic treatment of uncomplicated acute bronchitis is not recommended, regardless of the duration of cough 1.
- Patient satisfaction with the office visit does not depend on receipt of an antibiotic, but instead is most dependent on the patient-physician communication 1. It is essential to weigh the benefits and risks of antiviral therapy, considering the high cost of the newer drugs and the possibility of the emergence of viral resistance against the degree to which the duration of symptoms and illness is shortened 1.
From the FDA Drug Label
Oseltamivir phosphate for oral suspension is indicated for the treatment of acute, uncomplicated illness due to influenza A and B infection in patients 2 weeks of age and older who have been symptomatic for no more than 48 hours. The management of acute bronchitis in a patient with confirmed Influenza A virus infection is to treat the influenza infection with oseltamivir phosphate as indicated, but the drug label does not provide specific guidance on the management of acute bronchitis.
- The treatment of influenza A with oseltamivir phosphate may help alleviate symptoms, but
- The label does not address the treatment of acute bronchitis directly. 2 No conclusion can be drawn about the management of acute bronchitis from the provided drug label.
From the Research
Management of Acute Bronchitis in Patients with Influenza A Virus Infection
The management of acute bronchitis in patients with confirmed Influenza A virus infection involves symptomatic treatment, as the condition is usually caused by a virus 3, 4.
Symptomatic Treatment
- A sore throat can be treated locally
- A troublesome cough, particularly at night, can be managed with antitussive agents for a limited period (14 days) 3
- If bronchial mucus is viscous and difficult to clear, short-term treatment with a secretolytic or mucolytic substance may be justified 3
Antiviral Medications
- Antiviral medications such as oseltamivir and zanamivir can be used to treat influenza A virus infection 5, 6
- These medications can reduce the duration of illness by 0.5-1.5 days when given within 48 hours of the onset of symptoms 5, 6
- Zanamivir has been shown to relieve influenza symptoms a median of 1.5 days earlier in patients with influenza A and B virus infections 7