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American Family Physician Oct 2016Cough is the most common illness-related reason for ambulatory care visits in the United States. Acute bronchitis is a clinical diagnosis characterized by cough due to... (Review)
Review
Cough is the most common illness-related reason for ambulatory care visits in the United States. Acute bronchitis is a clinical diagnosis characterized by cough due to acute inflammation of the trachea and large airways without evidence of pneumonia. Pneumonia should be suspected in patients with tachypnea, tachycardia, dyspnea, or lung findings suggestive of pneumonia, and radiography is warranted. Pertussis should be suspected in patients with cough persisting for more than two weeks that is accompanied by symptoms such as paroxysmal cough, whooping cough, and post-tussive emesis, or recent pertussis exposure. The cough associated with acute bronchitis typically lasts about two to three weeks, and this should be emphasized with patients. Acute bronchitis is usually caused by viruses, and antibiotics are not indicated in patients without chronic lung disease. Antibiotics have been shown to provide only minimal benefit, reducing the cough or illness by about half a day, and have adverse effects, including allergic reactions, nausea and vomiting, and Clostridium difficile infection. Evaluation and treatment of bronchitis include ruling out secondary causes for cough, such as pneumonia; educating patients about the natural course of the disease; and recommending symptomatic treatment and avoidance of unnecessary antibiotic use. Strategies to reduce inappropriate antibiotic use include delayed prescriptions, patient education, and calling the infection a chest cold.
Topics: Acute Disease; Bronchitis; Cough; Diagnosis, Differential; Humans
PubMed: 27929206
DOI: No ID Found -
American Family Physician Dec 2010Cough is the most common symptom bringing patients to the primary care physician's office, and acute bronchitis is usually the diagnosis in these patients. Acute... (Review)
Review
Cough is the most common symptom bringing patients to the primary care physician's office, and acute bronchitis is usually the diagnosis in these patients. Acute bronchitis should be differentiated from other common diagnoses, such as pneumonia and asthma, because these conditions may need specific therapies not indicated for bronchitis. Symptoms of bronchitis typically last about three weeks. The presence or absence of colored (e.g., green) sputum does not reliably differentiate between bacterial and viral lower respiratory tract infections. Viruses are responsible for more than 90 percent of acute bronchitis infections. Antibiotics are generally not indicated for bronchitis, and should be used only if pertussis is suspected to reduce transmission or if the patient is at increased risk of developing pneumonia (e.g., patients 65 years or older). The typical therapies for managing acute bronchitis symptoms have been shown to be ineffective, and the U.S. Food and Drug Administration recommends against using cough and cold preparations in children younger than six years. The supplement pelargonium may help reduce symptom severity in adults. As patient expectations for antibiotics and therapies for symptom management differ from evidence-based recommendations, effective communication strategies are necessary to provide the safest therapies available while maintaining patient satisfaction.
Topics: Acute Disease; Anti-Bacterial Agents; Bronchitis; Complementary Therapies; Diagnostic Techniques, Respiratory System; Humans
PubMed: 21121518
DOI: No ID Found -
American Family Physician Nov 2020
Review
Topics: Anti-Bacterial Agents; Antimicrobial Stewardship; Bronchitis; Humans
PubMed: 33118784
DOI: No ID Found -
BMJ Clinical Evidence Jul 2015Acute bronchitis affects more than 40 in 1000 adults per year in the UK. The causes are usually considered to be infective, but only around half of people have... (Review)
Review
INTRODUCTION
Acute bronchitis affects more than 40 in 1000 adults per year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens. The role of smoking or of environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear. One third of people may have longer-term symptoms or recurrence.
METHODS AND OUTCOMES
We conducted a systematic review, aiming to answer the following clinical question: What are the effects of treatments for acute bronchitis in people without chronic respiratory disease? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2015 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).
RESULTS
At this update, searching of electronic databases retrieved 420 studies. After deduplication and removal of conference abstracts, 306 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 245 studies and the further review of 61 full publications. Of the 61 full articles evaluated, three updated systematic reviews and three RCTs were added at this update. We performed a GRADE evaluation for 12 PICO combinations.
CONCLUSIONS
In this systematic review we categorised the efficacy for six intervention-comparison combinations, based on information about the effectiveness and safety of the following interventions: antibiotics, antihistamines, antitussives, beta2 agonists (inhaled), and expectorants/mucolytics.
Topics: Acute Disease; Administration, Inhalation; Adrenergic beta-2 Receptor Agonists; Anti-Bacterial Agents; Antitussive Agents; Bronchitis; Expectorants; Histamine Antagonists; Humans; Treatment Outcome
PubMed: 26186368
DOI: No ID Found -
American Family Physician Mar 1998Acute bronchitis is a lower respiratory tract infection that causes reversible bronchial inflammation. In up to 95 percent of cases, the cause, is viral. While... (Review)
Review
Acute bronchitis is a lower respiratory tract infection that causes reversible bronchial inflammation. In up to 95 percent of cases, the cause, is viral. While antibiotics are often prescribed for patients with acute bronchitis, little evidence shows that these agents provide significant symptomatic relief or shorten the course of the illness. In a few small studies, bronchodilators such as albuterol have been found to relieve some symptoms of acute bronchitis. Increased attention is being given to the role of Chlamydia species in acute bronchitis and adult-onset asthma. Studies in progress may help to clarify the importance of these organisms in acute bronchitis and to determine whether early treatment can prevent or ameliorate asthma.
Topics: Acute Disease; Asthma; Bronchitis; Bronchodilator Agents; Diagnosis, Differential; Humans; Patient Education as Topic; Teaching Materials
PubMed: 9531910
DOI: No ID Found -
Annals of Internal Medicine Dec 2000Acute bronchitis is an acute cough illness in otherwise healthy adults that usually lasts 1 to 3 weeks. This review describes the pathophysiology of the condition and... (Review)
Review
Acute bronchitis is an acute cough illness in otherwise healthy adults that usually lasts 1 to 3 weeks. This review describes the pathophysiology of the condition and provides a practical approach to the evaluation and treatment of adults with uncomplicated acute bronchitis. Practical points to be made are:1. Respiratory viruses appear to cause the large majority of cases of uncomplicated acute bronchitis.2. Pertussis infection is present in up to 10% to 20% of adults with cough illness of more than 2 to 3 weeks' duration. No clinical features distinguish pertussis from nonpertussis infection in adults who were immunized against pertussis as children.3. Transient bronchial hyperresponsiveness appears to be the predominant mechanism of the bothersome cough of acute bronchitis.4. Ruling out pneumonia is the primary objective in evaluating adults with acute cough illness in whom comorbid conditions and occult asthma are absent or unlikely. In the absence of abnormalities in vital signs (heart rate > 100 beats/min, respiratory rate > 24 breaths/min, and oral body temperature > 38 degrees C), the likelihood of pneumonia is very low.5. Randomized, placebo-controlled trials do not support routine antibiotic treatment of uncomplicated acute bronchitis.6. Randomized, placebo-controlled trials have shown that inhaled albuterol decreases the duration of cough in adults with uncomplicated acute bronchitis.7. Intervention studies suggest that antibiotic treatment of acute bronchitis can be reduced by using a combination of patient and physician education. Decreased rates of antibiotic treatment are not associated with increased utilization, return visits, or dissatisfaction with care.
Topics: Acute Disease; Adult; Algorithms; Anti-Bacterial Agents; Antitussive Agents; Bronchitis; Bronchodilator Agents; Humans
PubMed: 11119400
DOI: 10.7326/0003-4819-133-12-200012190-00014 -
American Family Physician Oct 2016
Topics: Acute Disease; Bronchitis; Humans
PubMed: 27929221
DOI: No ID Found -
Lippincott's Primary Care Practice 1998
Review
Topics: Acute Disease; Adult; Bronchitis; Child; Clinical Protocols; Diagnosis, Differential; Humans; Nursing Assessment; Primary Health Care
PubMed: 9883159
DOI: No ID Found -
The Nurse Practitioner Oct 2013Acute bronchitis affects millions of individuals, significantly impacting patient health and the healthcare industry. Understanding evaluation and treatment guidelines... (Review)
Review
Acute bronchitis affects millions of individuals, significantly impacting patient health and the healthcare industry. Understanding evaluation and treatment guidelines for acute bronchitis allows the nurse practitioner to practice comprehensive care for patients. This article reviews evidence-based practices when caring for the patient with acute bronchitis, promoting optimization of healthy outcomes.
Topics: Acute Disease; Bronchitis; Evidence-Based Nursing; Humans; Nurse Practitioners; Nursing Assessment; Practice Guidelines as Topic
PubMed: 24042360
DOI: 10.1097/01.NPR.0000434092.41971.ad -
Expert Review of Anti-infective Therapy Jul 2016Acute bronchitis is a self-limiting infectious disease characterized by acute cough with or without sputum but without signs of pneumonia. About 90% of cases are caused... (Review)
Review
INTRODUCTION
Acute bronchitis is a self-limiting infectious disease characterized by acute cough with or without sputum but without signs of pneumonia. About 90% of cases are caused by viruses.
AREAS COVERED
Antibiotics for acute bronchitis have been associated with an approximately half-day reduction in duration of cough. However, at follow-up there are no significant differences in overall clinical improvement inpatients treated with antibiotics compared with those receiving placebo. Despite this, antibiotics are administered to approximately two thirds of these patients. This review discusses the reason for this antibiotic overprescription. Other therapies targeted to control symptoms have also demonstrated a marginal or no effect. Expert commentary: Clinicians should be aware of the marginal effectiveness of antibiotic therapy. Some strategies like the use of rapid tests, delayed prescribing of antibiotics and the use of leaflets for patients have been associated with a reduction of their unnecessary utilization.
Topics: Acute Disease; Anti-Bacterial Agents; Bronchitis; Clinical Trials as Topic; Drug Prescriptions; Humans; Inappropriate Prescribing; Practice Guidelines as Topic; Treatment Outcome
PubMed: 27219826
DOI: 10.1080/14787210.2016.1193435