Acute bronchitis

• Acute bronchitis:

  • Self-limiting lower respiratory tract infection which causes inflammation in the bronchial airways
  • Clinical diagnosis characterised by cough - caused by acute inflammation of the trachea and large airways
  • No evidence of pneumonia
• Causes:

  • Most commonly caused by a viral infection - rhinovirus, enterovirus, influenza A and B, parainfluenza, RSV
  • Bacteria are detected in 1-10% of cases - Streptococcus pneumoniae, Haemophilus influenzae
• Acute bronchitis is usually a mild, self-limiting illness:

  • Cough usually lasts about 2-3 weeks
  • Most people recover fully with no residual symptoms
  • Some people will have a cough for more than 4 weeks, and in a small amount of people the cough will persist for up to 6 months (post-bronchitis syndrome)
  • Pneumonia may occur as a complication, particularly in older people
• A chest x-ray will be normal in acute bronchitis, unlike in pneumonia which will show new infiltrate (consolidation)
• Do not routinely offer an antibiotic to treat an acute cough associated with acute bronchitis:

  • Advise self care measures
  • Safety netting
  • Consider a back up antibiotic prescription
  • First line antibiotic if systemically very unwell or high risk of complications = doxycycline 5 day course