Bronchitis

ACUTE BRONCHITIS

• Cough and sputum (main symptoms)

• Wheeze and dyspnoea (fever or haemoptysis uncommon)

• Usually viral infection

• Can complicate chronic bronchitis usu. due to Haemophilus influenzae and Streptococcus pneumoniae

• Scattered wheezes on auscultation ± fever or haemoptysis (uncommon)

Outcome Improves spontaneously in 4–8 d in healthy patients.

Treatment

• Symptomatic treatment

• Inhaled bronchodilators for airflow limitation

• Antibiotics usually not needed, esp. if previously healthy

• Use antibiotics if evidence of acute bacterial infection with fever, purulent sputum (e.g. amoxicillin 500 mg tds for 5 d; use doxycycline 200 mg stat, then 100 mg/d for 5 d if mycoplasma suspected)

CHRONIC BRONCHITIS

Definition: chronic productive cough for at least 3 successive mths in 2 successive years:

• Wheeze, progressive dyspnoea

• Recurrent exacerbations with acute bronchitis

• Occurs mainly in smokers

See COPD ( 135)