Various myths loom about bronchitis and does the question that is bronchitis contagious, strike your head too? If yes, then, here is your answer. Acute bronchitis is contagious and if someone around you has it, then you might be the next person to catch it, like Pokémon ball.
Everyday items and interactions may make you susceptible to acute bronchitis. Items like door handles, ATM machine buttons, computer keyboards, remote controls, phone booth phones can have traces of the virus which you can easily contract.
On other times, an infected person in your vicinity may sneeze or cough on your face, transferring their disease. But, you should not panic, have your hands washed frequently and see a doctor if you feel ill. To be more precise, only acute Bronchitis is contagious while chronic Bronchitis has other ways to twirl you than being contagious.
What Is Bronchitis?
Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. People who have bronchitis often cough up thickened mucus, which can be discolored, white, yellow-grey or green. There are two types of bronchitis.
which means your airways are irritated over and over. This type lasts for a few months or longer, and usually comes back year after year. Things that irritate your lungs, like dust, chemicals, or smoke from a fire or cigarettes, usually cause it. Chronic bronchitis isn’t contagious, but it’s a serious health problem that requires a doctor’s care.
which can last for 1 to 3 weeks. It’s usually caused by cold or flu viruses. Since these viruses are contagious, acute bronchitis usually is, too.
Often developing from a cold or other respiratory infection, acute bronchitis is very common. Chronic bronchitis, a more serious condition, is a constant irritation or inflammation of the lining of the bronchial tubes, often the smoker’s cough.
Acute bronchitis usually is self-correcting condition which improves within a few days without lasting effects, although you may continue to cough for weeks. However, if you have repeated episodes of bronchitis for most of the days in three months per year: you may have chronic bronchitis, which requires medical attention. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD).
Is Bronchitis Contagious?
Acute bronchitis is a common self-limiting respiratory infection characterized by the inflammation bronchial tubes. The inflammation of bronchial tubes takes place in the mucus membranes, located on the bronchitis wall lining. As the inflammation increases, the tubes swell that result in the interference of other air passageways. This is the preeminent cause of breathlessness in patients suffering from bronchitis.
Acute bronchitis lasts about 10 days but the coughing may persist for a longer time. As a person coughs, he or she is likely to spread the disease through the air. The pathogen (virus or bacterium) may spread through physical contact as well, like touching surfaces with unwashed hands. The tiny droplets that come out of the mouth and nose of an infected person contains millions of pathogenic particles that have the potential to disseminate in an area of 1 meter or more.
These coughed out particles are suspended in the air. Eventually, as they settle on to the near surfaces, they actively propagate for 24 hours. If somebody touches the surfaces, where these particles land, they can contract the pathogen with a mere touch. Now, if someone, who has touched the pathogen-contaminated surfaces, touches somebody without washing his hands, he can still spread the virus or bacteria to others.
This can be an associated reason of as to why acute bronchitis is one of the most common causes for people to visit a doctor.
You might be wondering whether all kinds of bronchitis are contagious? The answer to your question is no, not all types of bronchitis are contagious example being: chronic bronchitis. Amongst the many causative viral and bacterial strains of acute bronchitis; all of them are contagious. However, viral acute bronchitis and pertussis causing bronchitis are highly contagious. As the clock ticks around, a person’s likelihood to spread the disease decreases, because the potency of causative pathogen is attenuated with time.
At other times, acute bronchitis can be triggered by external conditions, such as:
- Breathing in an irritant substance environment. These irritants include smog, chemicals in daily use products or tobacco smoke. These irritants do not directly cause acute bronchitis but they weaken the immune system so a person becomes more likely to get infected. However, more research is warranted to establish an accurate link between smoking and causative acute bronchitis.
- Occupational exposure to irritants like grain dust, fabric fibres, strong acids, chlorine and ammonia, fumes can contribute towards the disease as well. Bronchitis caused by these substances is usually referred to as “occupational bronchitis” and the symptoms mitigate as the exposure to these substances end.
- Similarly, if a person is allergic to some irritants, like pollen grains during change of weather, they are likely to have a compromised immunity. Consequently, this would result in a person becoming vulnerable to infections by producing excessive amounts of mucus.
However, acute bronchitis triggered by these irritants is not contagious in nature.
Furthermore, when people who already suffer from asthma, catch acute bronchitis infection; they are referred to as suffering from “Asthmatic Bronchitis”. These people are often more affected by environmental irritants as compared to patients who only suffer from acute bronchitis.
Who Is At Risk Of Developing Acute Bronchitis?
Vulnerable groups like infants and the elderly are highly susceptible to bronchial infection. But how can you know if you are on a risk to develop bronchitis? To know, if you are at a risk, let’s look at the risk factors that can increase your likelihood of developing bronchitis.
- People who smoke or live around people who smoke are at a high risk of developing both acute bronchitis and chronic bronchitis. A single puff can cause damage to cilia.
- People who have a compromised immune system are prone to developing bronchitis. This is why infants and old person are at a greater risk of developing the disease. Low resistance may also be a result of another acute illness such has cold or a chronic immune suppressing disease.
- Increased exposure to irritants can also increase the risk.
- Gastric reflux can also be a contributor in this case. Repeated episodes of heartburn can cause throat irritation and bronchitis.
Understand Your Disease: The Pathogens for Contagious Bronchitis
Acute bronchitis is caused by lung irritants and infections.
- Viral Pathogens: The viruses that contribute towards causing influenza are responsible for causing acute bronchitis. Viruses contribute in about 85% to 95% of all acute bronchitis cases. The infection takes place in the upper airways and the infection can be caused by influenza A, influenza B, parainfluenza, coronavirus, respiratory syncytial virus, rhinovirus and metapneumovirus strains.
- Bacterial Pathogens: It has long been believed that bacterial pathogens that contribute towards pneumonia (eg, Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis or gram-negative bacilli) can also cause bronchitishowever, samples from bronchial biopsy have never shown a bacterial attack.
Therefore, this has been a controversial debate that links bacteria with bronchitis. No concrete evidence has supported the notion of bacterial invasion as a cause of acute bronchitis but there is an exception of patients with tracheostomy (incision in the windpipe to relieve breathing obstruction), endotracheal intubation (tube placement in the windpipe for emergency situation) or worsened chronic bronchitis.
In other rare cases, a bacterium can contribute towards causing acute bronchitis. Bordetella pertussis can cause whooping cough. The bacteria attach to the cilia in the lining of upper respiratory system, the bacteria release toxic substances causing damage to the cilia which cause swelling in the airways. This rare type of acute bronchitis is highly contagious.
Details Of The Microbial Pathogens
Following are the details of the microbial-pathogens that can lead to bronchitis.
As previously stated, the various strains of influenza causing viruses also contribute towards acute bronchitis. The strains are similar which may become confusing while diagnosing the illness. However, the symptoms of flu disappear in a week; on the other hand acute bronchitis may persist for several days. The salient features of acute bronchitis caused by influenza virus include, cough, fever and purulent sputum.
Acute bronchitis is rarely caused by a bacterial pathogen. In this rarely caused bacterial nature of acute bronchitis, the following three bacterial strains have been found responsible:
It is a common cause of infections in upper respiratory tract found in young adults. These infections are characterized by persisted cough that may continue for four to six weeks and pharyngitis (inflammation of pharynx causing sore throat). Serological (tests of different antibody levels) tests suggest that this bacterial strain when found in mild upper respiratory infections other than pneumonia, can cause other symptoms such as head cold, purulent sputum, shedding off tracheal epithelial cells (as the mycoplasma pnuemoniae adhere to them) and sore throat. This can be helpful in diagnosing rare cases of acute bronchitis caused by mycoplasma pneumoniae.
A study was conducted on 63 young acute bronchitis patients. Out of these 63 participants, only 3 were suffering from acute bronchitis caused by this bacterial strain. In rare cases caused by this strain of bacteria, the highlighted symptoms included pharnygitis, laryngitis (larynx inflammation), sore throat and low degree fever.
It is also known as whooping cough and it is highly contagious respiratory infection. Bordetella pertussia and B. parapertussis are the bacterial pathogens that cause pertussis. Testing for pertussis is recommended by American Academy of Family Physicians, if a person is not previously vaccinated for pertussis and the cough he/she experiences has a whooping sound that doesn’t reduce for three weeks or more. Bordetella pertussis can develop acute bronchitis, only in this situation; antibiotics can help reduce the symptoms. However, it only accounts for 1% of acute bronchitis cases in the US.
Can Flu Cause Bronchitis?
Yes, cold or flu can develop into acute bronchitis. As acute bronchitis can be caused by the influenza strains, it is likely that a prolonged flu develops into acute bronchitis or other serious respiratory tract infection. As the strains are contagious in nature, flu that develops acute bronchitis has a potential to spread onto people who are in close contact, eliciting its contagious nature.
Having seasonal flu vaccinations can prevent influenza which in turn helps from developing acute bronchitis, caused by these influenza causing strains. If an acquired immunity is built against these viral strains, the specific antibodies neutralize the antigens as they enter a human body, before symptoms of a disease start to manifest. Read pathogens section for better understanding.
Clinical Features of Acute Bronchitis
In acute bronchitis the swelling of mucus membrane is followed by increased mucus production. This increased mucus production may also be accompanied by discoloration. Microscopic examinations show thickening of bronchial and tracheal mucosa at the area of inflammation.
The span of bronchitis can reach from few days to many weeks depending on the type of bronchitis developed in a person. As the inflammation increase, symptoms start to manifest.
The symptoms of bronchitis are not very specific in nature and they may overlap with other medical conditions which include postnasal drip, chronic cough, pneumonia and some other chronic obstructive pulmonary disease. The commonly observed symptoms may include, shortness of breath, low degree fever, wheezing, chest pain, chest tightness, sore throat and persistent cough with excessive sputum secretion (sputum may be clear or discolored).
Distinction Between Acute Bronchitis And Upper Respiratory Tract Infection
It is hard to distinguish acute bronchitis from other respiratory conditions. In the first few days during the onset of acute bronchitis, the symptoms can be confused with other upper respiratory infections.
However, it has been found that treatment for respiratory infections can help mitigate symptoms of acute bronchitis as it can coexist with other viral upper respiratory infections. It is very important to distinguish acute bronchitis from pneumonia, as pneumonia is caused by bacteria.
If acute bronchitis is mistaken as pneumonia, the medications will not help improve the condition and may increase a patient’s tendency to develop antibiotic resistance. Fever in acute bronchitis usually misleads doctors to diagnosis the condition with either influenza or pneumonia. Other symptoms of acute bronchitis are cough and sputum productions which can also be deceptive as these symptoms are not very specific. This may be followed by chest wall tenderness and wheezing.
It is suggested, however, that if the cough does not seem to reduce by the 5th day of onset, acute bronchitis should be considered as a potential respiratory infection. According to studies, cough in acute bronchitis patients usually lasts from 10 to 20 days, while in 25% cases, cough disappears by 14th day. Another study suggests that the median cough duration is 18 days, while at other times cough may persist for about 24 days.
What Does Your Sputum Spill Out About The Disease?
In about 50% cases of acute bronchitis, purulent sputum is reported. The term purulent sputum is referred to sputum which consists of white blood cells, cellular debris, dead tissues and mucus. Purulent sputum can be off-white, yellow or green in color.
In a study, published by US National Library of Medicine, National Institutes of Health, it was found out by experts in 1955 that a green discoloration of sputum is caused by the release of crystallized peroxidase. This enzyme is released by leukocytes that are triggered as immune response; therefore, sputum coloration cannot always tell if the cause of acute bronchitis is viral or bacterial. It is usually said that commonly green coloration of sputum occurs in bacterial form of acute bronchitis.
However, in viral acute bronchitis, sputum may change colors from off white to yellowish green over days. This discoloration does not suggest that the nature of the disease has changed, that is, viral acute bronchitis has been changed into bacterial acute bronchitis. But it merely means that the inflamed cells are moving into the airway and causing discoloration of sputum.
Wheezing In Acute Bronchitis
Patients with acute bronchitis may also reveal wheezing which is followed by bronchospasm. Bronchospasm is the narrowing of airway caused by inflammation which can cause difficulty in breathing. In about 40% acute bronchitis cases, bronchospasm is a sign found in physical examination.
A coarse rattling respiratory sound may also be noticed by your doctor on auscultation, which gradually goes away with coughing. Hardening of otherwise soft lung tissues is also caused in acute bronchitis and this condition is referred to as pulmonary consolidation. These symptoms may disappear in five to six weeks.
Acute Bronchitis Diagnosis
While diagnosing acute bronchitis, chest X-rays are carried out. The X-ray results are not very specific to acute bronchitis but sometimes subtle changes in the bronchial walls in the lower lobes are indicated in the X-rays.
White Blood Cell count test is also administered in a respiratory infection. The white blood count is slightly elevated in acute bronchitis while in other respiratory infections like pneumonia; the white blood cell count is significantly increased.
- Chest X-ray: Chest X-ray is usually carried out by your doctor under certain situations. The most important reason to have a chest X-ray done is to exclude the possibility of pneumonia from the diagnosis. Patients with a pulse rate over 100/minute, respiratory rate over 24 breaths/minute, signs of consolidation and body temperature over 38 oC are usually recommended to have a chest x ray. However, elderly people over the age of 65 may have pneumonia without fever.
- Lung Function Test: The lung function tests measure the amount of air inhaled and exhaled, how fast does a person inhale and exhale, the amount of oxygen carried into the blood stream and the strength of lung muscles. These examinations will let the doctor know about the health of the respiratory system and severity of bronchitis. The doctor may also examine the sputum sample and deduce the cause of infection by the discoloration.
- Procalcitonin Test: A relatively new diagnostic test known as procalcitonin (PCT) test is used. It is a specific markers of bacterial infection. It also helps in knowing the degree of sepsis in a patient.
Sepsis: is serious and sometimes life threatening inflammatory response to a bacterial infection. It is generally prescribed in combination with other tests in severe illnesses. However, in cases of acute bronchitis it can help in distinguishing between viral or bacterial acute bronchitis.
Procalcitonin: is a peptide precursor of a hormone calcitonin which is responsible for calcium homeostasis. The blood level of procalcitonin in a healthy person is below 0.1 microgram/liter. However, the levels rise up to a significant value in response to a proinflammatory stimulus of a bacterial origin. This rise takes place in response to cytokines stimulation by bacterial infections. But, in viral infections, these levels are not significantly high because procalcitonin up regulation is blocked by the interferone-gamma released in response to a viral attack. This difference in response to different pathogens helps in distinguishing between bacterial and viral pathogen attack.
In meta analysis of procalcitonin serum levels from 4221 patients who suffered with acute respiratory infections, improved treatment results were found in procalcitonin guided decision making. It led to reduction in antibiotic exposure after better identification of the etiological agent involved. After these meta-analyses concluded; diagnosis of non pneumonic respiratory infections was formulated on procalcitonin parameters. These parameters, however, need to be validated by more clinical trials. With the availability of more clinical assessments based on assays of procalcitonin, a better diagnostic modality can be added to the clinical practices at a larger scale. The proposed parameters are as follows:
- Procalcitonin <0.10 microgram/liter: Strongly discourage antibiotic
- Procalcitonin <0.25 microgram/liter: Discourage antibiotic
- Procalcitonin >0.25 microgram/liter: Encourage antibiotic
- Procalcitonin >0.50 microgram/liter: Strongly encourage antibiotic
In severe infections, the blood procalcitonin levels can rise up to 100 microgram/liter.
Diagnostic Tests For Specific Causative Microbe Of Acute Bronchitis
To further investigate the cause of acute bronchitis, following are the diagnostic tests available for specific etiological agents:
- To look for influenza strains, rapid tests are conducted whose results can be received within 30 minutes. Some rapid diagnostic tests use analyzers such as immunoassays and immunofluorescence assays for accuracy.
- For the diagnosis of pertussis strains, cultures are made from nasopharyngeal swab. At other times, PCR testing is used in combination with cultures, as PCR tests are more sensitive and reliable in nature.
According to the clinicians, testing for Mycoplasma or Chlamydophila as the suspected cause of acute bronchitis is not a very sensible choice. However, the likelihood of these rare types of acute bronchitis causing bacterial strains increases at times of an endemic or outbreak.
For diagnosing Mycoplasma strains, serological tests are widely used which measure the levels of different antibodies triggered in a system by the bacterial invasion releasing disease causing antigens. For instance, IgM titers have shown increased levels after the seventh day on onset. IgA, IgM, and IgG levels are also examined. PCR (polymerase chain reaction) is also carried out to detect the antigen genome present in the human system. Another test used is cold agglutinin test. The cold agglutinin titers are found to increase in immune system malfunctioning. This is not a very commonly used test but rarely, cold agglutinin disease is caused by Mycoplasma and to check the likelihood of Mycoplasma, this test may be recommended. However, none of these tests have been unanimously endorsed by experts.
For identifying the presence of C.pnuemoniae, tests are not very definitive. This results in an empirical treatment. Laboratories are not well equipped with cell culture facilities which would culture nasopharyngeal samples to identify the presence of the strain. However, more commonly used tests include antibody tests, polymerase chain reaction (PCR), antigen detection and enzyme immunoassays. Results from different studies have shown high reliability and validity of PCR and enzyme immunoassays as compared with diagnosis made from cell cultures.
What Other Diseases Can Be Confused With Acute Bronchitis?
Before we go to discussing the differential diagnosis for acute bronchitis, let’s understand what differential diagnosis is and why it is important for doctors and patients. By differential diagnosis, your doctor rules out the possibility of diseases that have overlapping symptoms with the disease you are suffering from.
In respiratory infections, differential diagnosis is very crucial because the symptoms exhibited by a certain infection may also be showed by another disease. In such confusing situations, differential diagnosis becomes important so that an effective and disease-specific treatment can be given to the patient. Below are some respiratory infections which may have symptoms that resemble to the symptoms of acute bronchitis.
- Postnasal Drip Syndrome: In this condition, the regular mucus secretions are increased by many folds and they drop down the throat. The mucus may become increasingly thick and cause sore throat and irritation. Cough is also experienced in this case, as the mucus causes obstruction in the airways and the mucus is coughed up in to clear out the passage. This may continue for several days. It may occur due to hay fever, allergies, exposure to irritants, rhinosinusitis (commonly known as sinus) and vasomotor rhinitis.
- Asthma: With the initial onset of asthma symptoms, it is hard to make a distinction between asthma and acute bronchitis. Both are characterized by airway obstruction but in asthma a transient (short-lived) airway obstruction is experienced by the patient. Studies have also shown that about 65% patients who have had two to three episodes of bronchitis over the period of five years had developed mild asthma as well. In this situation, antibiotics may help reduce the symptoms. However, at other times when acute bronchitis is confused with asthma; antibiotics are rendered useless for improving the patient’s condition.
- Gastroesophageal Reflux: This is a digestive system disorder that affects the ring of muscles between esophagus and stomach. It is categorized by cough, which can be intermittent or persistent in nature. Cough in often followed by symptoms like sore mouth taste and heartburn.
- Pneumonia: It is a bacterial respiratory infection which is characterized by inflamed alveolar sacs. The symptoms start to manifest in 24 to 48 hours which include cough which may be dry at the beginning but later it is accompanied by sputum production, fever, difficulty in breathing or rapid breathing, increased heart rate, sweating, shivering, chest pain and joint pain. Pneumonia, at many times is confused with acute bronchitis. But, after a chest x ray, the distinction between the conditions can be made.
Acute Bronchitis Treatment
Antibiotics are being inappropriately prescribed and misused throughout the United States, according to experts at the Centers for Disease Control and Prevention (CDC). Published in the journal AJMC, the new study discusses the prevalence of antibiotics use among outpatients, specifically those using a commercial health plan. It concludes that the misuse of antibiotics tops the list of why antibiotic resistance is growing.
Authored by Rebecca Roberts, Lauri Hicks and Monina Bartoces, who are health experts at the “Get Smart: Know When Antibiotics Work Program (CDC)”, the paper showed that most health plans were not adequately avoiding the use of antibiotics in the management of acute bronchitis.
The treatments for acute bronchitis have seen a gap between recommendation and original clinical practice. In short, the recommended treatment is:
To control the symptoms of soar throat: NSAID like Ibuprofen, Aspirin and Naproxen.
For acute Bronchitis caused by Influenza strains: Neuraminidase inhibitors such as; Oseltamivir or Zanamivirare (administered within the 48 hours of symptom manifestation).
To control cough: No evidence of effectiveness of frequently used following drugs: Cough suppressants (anti-tussives), Bronchodialtors, Anti-inflammatory and Anti-histamines.
Use of antibiotics:
- For uncomplicated bronchitis routine use of antibiotics is discouraged. However, Amoxicillin for 5 days or Doxycycline for 5 days is recommended for adults along with the guidelines given by NICE.
- For bacterial origin (Mycoplasms pneumonia or Chlamydophila pneumonia) acute bronchitis recommended antibiotics are: Flouroquinolones, Macrolides and Tetracyclines.
How To Control Cough?
The duration of cough is not usually affected by the use of antibiotics. However, ibuprofen shows some improvement in patients. It helps in reducing the cough, in patients, by just a marginal change.
However, both antibiotics and anti-inflammatory drugs did not cause any cough relapse or worsening of other symptoms.
Cough suppressants (antitussives) given to mitigate cough in acute bronchitis patients are found to have limited effect. American College of Chest Physicians (ACCP) found from evidence-based practice guidelines that non-specific anti-tussives such as codeine and dextromethorphan have limited efficacy for cough relief in acute bronchitis patients.
Another systemic review was carried out to find the efficacy of over-the-counter medications for acute cough in acute bronchitis patients. However, no concrete evidence was found in support or in opposition of the efficacy of antihistamine and decongestant drugs. Clinical trials have not supported the role of mucolytic agents and expectorants (mucus reducing drugs).
For sore throat, many over the counter non-steroidal anti-inflammatory drugs are used which include ibuprofen, aspirin and naproxen.
For acute bronchitis caused by influenza strains, treatment with neuraminidase inhibitors such as oseltamivir or zanamivirare is found to be effective. These drugs should be administered within 48 hours of symptom manifestation for drug efficacy.
Clinical practice guidelines and systematic reviews have shown that the routine use of bronchodilators, such as most commonly used beta-2-agonists for acute bronchitis has not showed a significant improvement. Beta-2-agonists can be administered orally and in inhaler form.
Studies have shown that administering beta-2-agonists in adults and children with acute bronchitis did not make any statistically significant improvement.
As beta-2-agonists are bronchodilators, they help in dilation of bronchi and bronchioles to reduce airway obstructions, it was shown in the studies that cough was slightly reduced in acute bronchitis patients who has airway obstruction. On the contrary, in acute bronchitis patients without airway obstruction, cough stayed unaffected after regularly administered dosage. In a seven day long observation, daily cough scores and cough persistence over days stayed unaffected in these patients.
According to the estimation, 60-90% times, acute bronchitis is treated with broad spectrum antibiotics. The medications are not only expensive but they are ineffective against the condition, as the cause is mostly found to be viral. The use of antibiotics is rendered useless and over prescription of antibiotics has become a serious global health problem as antibiotic resistance has drastically increased over the years.
According to studies published in the British Medical Journal (BMJ), using antibiotics, non steroidal anti inflammatory drugs like ibuprofen and placebo pills to compare their efficacy over days have shown significant results. The findings showed no significant improvement in acute bronchitis patients who used antibiotics. The duration of cough was not affected by the use of antibiotics.
However, ibuprofen showed some improvement in patients. Ibuprofen helped the patients reduce the cough by just a marginal change. However, both antibiotics and inflammatory drug did not cause any cough relapse or worsening of other symptoms.
The role of antibiotic therapy for treating acute bronchitis has been very controversial over the years. Many studies have been conducted in this regard and below are some of the studies that discussed the role of antibiotic in acute bronchitis in detail.
- In 2012, meta analysis of 15 randomized trials were carried out. The effect of antibiotics was noted on two groups of participants; non smokers and smokers. A marginal improvement was noted. On the contrary, side effects leading to emergency department visits and antibiotic resistances clearly outweighed the marginal benefit of the antibiotic.
- In another trial, 2061 participants with acute lower respiratory tract infections were assigned to several days of amoxicillin or placebo, by randomized selection. No significant change was observed in the duration of symptoms across patients of all age brackets.
It is worth noting that antibiotic resistance is emerging as a serious global problem due to which the guidelines from the National Institute for Health and Clinical Excellence (NICE) in the UK has discouraged treating uncomplicated conditions like acute bronchitis with antibiotics. According to their guideline, Amoxicilin drug should be given in a dose of TDS for five days to an adult. In addition to that, doxycycline drug is recommended in a dose of 200mg state, then 100 mg OD, for five days to an adult. But NICE went on to give the following recommendations:
- The use of all fluoroquinolones should be avoided as first line of defense in lower respiratory tract infections.
- For acute cough bronchitis, it is suggested that antibiotics should be of little benefit if co-morbidity exists (and that condition has a bacterial etiological agent).
- It has been suggested to consider a delay of seven days while taking antibiotics with advice.
- Symptoms resolutions can take three weeks.
- Consider immediate antibiotics if the patient is above 80 years of age and has been hospitalized in past years with oral steroid prescription.
- Diabetic, congestive heart failure or 65 years with two of above.
- Consider CRP test, if antibiotic is considered.
- If CRP<20mg/l. no antibiotics, 20-100mg/l delayed antibiotics, CRP>100mg immediate antibiotics.
For patients with a bacterial origin of etiological agent, the treatment plan will include antibiotics. Mycoplasms pneumonia or Chlamydophila pneumonia are susceptible to flouroquinolones, macrolides and tetracyclines. Routine use of antibiotics is discouraged but the dose can be administered by following the guidelines. Acute bronchitis as a result of these strains, is characterized by prolonged cough and upper respiratory tract inflammation.
For patients who suffer from Pertussis causing strain, antibiotics are likely to provide benefit to the symptoms if the medication begins as early as in the first week of the onset of infection. However, the treatment should be closely monitored and overuse of antibiotics should be avoided.
Treatment strategies include using erythromycin, 500 mg, four times daily for 14 days. Gastrointestinal side effects and a rare risk of cardiac arrest are associated with erythromycin. Clarithromycin, 500mg, twice a day for 14 days or azithromycin, 500 mg oncea day for for days are also another antibiotic therapy strategy. Due to the side effects of erythromycin, as described earlier, the dose of clarithromycin or azithromycin is preferred.
for pertussis. On the other hand, acute bronchitis caused by influenza virus strain A; is recommended to be treated with oseltamivir (antiviral blocker) or zanamivir (neuraminidase inhibitor for viral pathogen). As indicated by American Academy of Family Physicians, often patient expectation leads to antibiotic prescription.
About 55% are reported to believe that antibiotics are the solution for their upper respiratory tract infections and nearly 25% take antibiotics for their infection as self-medication. In light of this, the American College of Chest physicians (ACCP) has discouraged routine prescription of antibiotics and it has urged the physicians to explain the reasoning to their patients who expect an antibiotic prescription.
In addition, the guideline has recommended the use of antitussives, beta-agonist inhalers for patients with wheezing, inhaled corticosteroids, Echinacea, pelargonium and the use of dark honey in children. However, the use of expectorants and the use of beta-agonist inhalers in patients without wheezing is not recommended.
Furthermore, according to a study published in the New England Journal of Medicine (NEJM), guidelines from American College of Chest Physicians (ACCP) and Centers for Disease Control and prevention (CDC), the use of macrolides is recommended as first-line defense.
Home Remedies For Acute Bronchitis
Using humidifiers, which creates moisture in the air, is also recommended for a person with acute bronchitis to inhale. Inhaled moist air helps loosen the mucus in the nasal passages and the chest. The reduced thickness of mucus facilitates breathing.
It is also recommended for a person to increase liquid intake. Liquids like water or tea also help reduce mucus thickness. This will again help ease breathing and coughing out mucus. Mucus of reduced thickness helps in a runny nose which helps the person blow out mucus out of their system with ease.
How Does it Spread? Ways To Prevent Bronchitis Spread To Others
The following precautionary measures may play a significant role to prevent the spread of bronchitis:
- Wear mask: this is for the person who is suffering from acute bronchitis and for the healthy people around him/her.
- Person who is suffering from acute bronchitis should repeatedly wash his/her hands.
- Person who is suffering from acute bronchitis should wash his/her bed linen.
- Don’t cook for your family without wearing a mask.
- Refrain from hugging and kissing an infant.
- While getting rid of the sputum, make sure you are not spitting it out causal in a public or an open space. Make sure, your sputum is discarded in the right way, so that the highly contagious sputum/mucus does not make a contact with other person.
Co-Author: Fizza Akbar