Acute bronchitis

Inflammation of the large bronchi in the lungs.

Usually caused by viruses or bacteria.

May last several days or weeks.

Characterized by cough and sputum production and symptoms related to the obstruction of the inflamed airways and mucous and shortness of breath and wheezing.

About half of cases related to a bacterial or viral agent.

Viral agents involved include rhinovirus, influenza and respiratory syncytial virus among others.

Can be a result of fumes from tobacco smoke and polluted air.

Clinical diagnosis and evaluation of sputum may be helpful.

Use of antibiotics in patients without underlying lung disease has limited benefit and their routine use is not recommended.

Up to 80% of all visits for bronchitis are treated with antibiotics in the US.

Antibiotic usage for uncomplicated acute bronchitis is not declining, as it is for otitis media and nonspecific upper respiratory infections, but may be worsening.

A Cochrane review of 17 trials comparing acute bronchitis treated with placebo versus antibiotics: antibiotics reduced overall and nighttime cough of an approximately half day reduction in duration of cough, in days feeling ill, and days with impaired activities with no significant differences in overall clinical improvement or limitations in work or other activities.

In the above studies there was a significant increase in adverse effects in the antibiotic group, particularly with gastrointestinal symptoms.

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