Bronchitis cough
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Summary
10 papers analyzed
These studies suggest that acute bronchitis is typically self-limited and does not benefit from routine antibiotics, while chronic bronchitis management may involve avoiding irritants and using inhaled medications, but the evidence for other treatments is limited.
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Understanding Bronchitis Cough: Acute and Chronic Perspectives
Acute Bronchitis Cough: Causes and Management
Definition and Symptoms of Acute Bronchitis
Acute bronchitis is a common respiratory condition characterized by a cough that may or may not produce phlegm, lasting up to three weeks. It is primarily caused by respiratory viruses, with bacterial infections being responsible for fewer than 10% of cases . The diagnosis is typically made when there is no evidence of pneumonia, asthma, or chronic obstructive pulmonary disease (COPD).
Treatment Approaches for Acute Bronchitis
The management of acute bronchitis focuses on symptomatic relief rather than the use of antibiotics, which are generally not recommended due to the viral nature of most cases . Antitussive agents can be used for short-term relief of coughing, but inhaled bronchodilators and expectorants are not typically beneficial. In cases of whooping cough, a macrolide antibiotic may be prescribed, especially if treatment is initiated early.
Recommendations for Clinical Practice
Routine investigations and medications are not advised for immunocompetent adult outpatients presenting with acute bronchitis unless the cough persists or worsens, warranting further assessment. Efforts should be made to reduce unnecessary antibiotic prescriptions to prevent resistance and other complications .
Chronic Bronchitis Cough: Causes and Management
Definition and Symptoms of Chronic Bronchitis
Chronic bronchitis is defined by a productive cough lasting for at least three months over two consecutive years, excluding other respiratory or cardiac causes. It is often caused by long-term exposure to irritants such as cigarette smoke and industrial pollutants, leading to chronic inflammation and, in severe cases, COPD.
Treatment Approaches for Chronic Bronchitis
The most effective way to manage chronic bronchitis is to avoid respiratory irritants. Treatment options include inhaled bronchodilators, such as short-acting β-agonists and ipratropium bromide, and oral theophylline. Combined therapy with long-acting β-agonists and inhaled corticosteroids may also be beneficial. However, prophylactic antibiotics, oral corticosteroids, expectorants, postural drainage, and chest physiotherapy are not recommended for routine use .
Recommendations for Clinical Practice
For acute exacerbations of chronic bronchitis, inhaled bronchodilators, oral antibiotics, and corticosteroids can be effective, although their impact on cough specifically has not been thoroughly evaluated. Central cough suppressants like codeine and dextromethorphan may provide short-term relief.
Special Considerations in Children
Chronic Cough Post-Acute Viral Bronchiolitis
In children, acute viral bronchiolitis can lead to a chronic cough lasting more than four weeks. However, there is limited evidence on the effectiveness of antibiotics, asthma medications, or inhaled osmotic agents like hypertonic saline for treating this condition. Further research is needed to develop effective management strategies for chronic cough in children post-bronchiolitis.
Conclusion
Both acute and chronic bronchitis are significant causes of cough, with distinct etiologies and management strategies. Acute bronchitis is primarily viral and self-limiting, requiring symptomatic treatment and minimal use of antibiotics. Chronic bronchitis, often linked to long-term exposure to irritants, requires avoidance of these irritants and targeted therapies to manage symptoms and prevent exacerbations. Understanding these differences is crucial for effective diagnosis and treatment, ultimately improving patient outcomes.
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