How is bronchitis treated?

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Research Analysis by Consensus

Consensus Meter

Yes20%

Possibly80%

No0%

Treatment Approaches for Bronchitis

Acute Bronchitis Treatment in Children: Complementary and Alternative Medicine (CAM)

Acute bronchitis in children is predominantly caused by viral infections, leading to a high but often inappropriate use of antibiotics. Complementary and alternative medicine (CAM) therapies have been explored as potential treatments to reduce antibiotic use and complement conventional therapies. Herbal remedies, particularly Pelargonium sidoides extract (EPs® 7630), have shown efficacy in several studies. Anthroposophic medicine, including ribwort-containing remedies, and homeopathic treatments like Monapax® and Droperteel® have also been investigated, though more randomized controlled trials (RCTs) are needed to confirm their effectiveness.

Chronic Bronchitis: Positive Expiratory Pressure (PEP) and Chest Physiotherapy

For chronic bronchitis, long-term treatment with chest physiotherapy, with or without the use of a positive expiratory pressure (PEP) mask, has been studied. Patients using PEP masks experienced significantly less cough and mucus production, fewer acute exacerbations, and reduced use of antibiotics and mucolytics compared to those receiving conventional chest physiotherapy. This suggests that PEP masks can help reduce morbidity and potentially slow the decline in lung function in chronic bronchitis patients.

Antibiotic Use in Severe Exacerbations of Chronic Bronchitis

Antibiotics are commonly used to treat purulent exacerbations of chronic bronchitis. Tetracycline, penicillin with streptomycin, and ampicillin are frequently prescribed, though comparative trials to determine the most effective antibiotic regimen are lacking. The choice of antibiotic often depends on the severity of the illness and the specific bacterial pathogens involved.

Innovative Bronchoscopic Treatments for Chronic Bronchitis

Several new bronchoscopic treatments are being investigated for chronic bronchitis. These include liquid nitrogen metered cryospray, bronchial rheoplasty, and balloon desobstruction, which aim to destroy hyperplastic goblet cells and excess submucous glands. Targeted lung denervation (TLD) is another technique that reduces acetylcholine release to decrease smooth muscle tone and mucus production. While these treatments show promise, larger RCTs are needed to confirm their efficacy and durability.

Bronchiolitis Management: Supportive Care and Pharmacologic Options

Bronchiolitis, a common viral respiratory infection in infants, is primarily managed with supportive care. This includes fluid replacement, gentle suctioning of nasal secretions, prone positioning, oxygen therapy, and respiratory support if necessary . Pharmacological treatments such as bronchodilators, corticosteroids, and antibiotics have not shown consistent clinical benefits and are not routinely recommended . Nebulized hypertonic saline may offer some benefit for patients with prolonged hospital stays, and high-flow nasal cannula can reduce intubation rates.

Conclusion

The treatment of bronchitis varies significantly depending on whether it is acute or chronic and the age of the patient. CAM therapies show potential for treating acute bronchitis in children, while PEP masks and innovative bronchoscopic treatments offer promising options for chronic bronchitis. Supportive care remains the cornerstone of bronchiolitis management, with limited evidence supporting the use of pharmacological agents. Further research, particularly RCTs, is essential to validate these treatment approaches and improve patient outcomes.