Acute bronchitis

Acute bronchitis is a common disease, seen in all age groups, where there is inflammation of the trachea and lower airways that causes cough and mucus production lasting up to 3 weeks (1,2).

• acute bronchitis is commonly caused by a viral or sometimes bacterial infection, but will resolve without antibiotic treatment, regardless of the cause
• may be caused by influenza and, in children, rhinoviruses and respiratory syncytial virus
• diagnosis is usually made if a previously well person presents with cough as the predominant symptom, in the absence of focal chest signs or severe systemic upset. Other symptoms may include sputum production, breathlessness or wheeze
• cough usually lasts for seven to ten days but can persist for three weeks

There may be subsquent bacterial infection following the initial viral assault. Common bacterial organisms involved include pneumococcus, H. influenzae and Staph. aureus.

Risk factors for the development of acute bronchitis include smoking and a damp or dusty environment.

Notes:

• antibiotic treatment is not routinely indicated for the majority of previously well patients with acute bronchitis
• patients should be reassured and offered a patient information leaflet explaining the nature of the illness, and the risks and limited efficacy of antibiotic treatment
• as the cough worsens, delayed prescriptions are also an option, as these are associated with reduced reattendance during the next month
• analgesics and antipyretics may be used where appropriate

References:

• (1) Singh A, Avula A, Zahn E. Acute Bronchitis. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448067/
• (2) Smith MP, Lown M, Singh S, Ireland B, Hill AT, Linder JA, Irwin RS; CHEST Expert Cough Panel. Acute Cough Due to Acute Bronchitis in Immunocompetent Adult Outpatients: CHEST Expert Panel Report. Chest. 2020 May;157(5):1256-1265. doi: 10.1016/j.chest.2020.01.044.