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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 -
Current Opinion in Pulmonary Medicine May 1995Acute bronchitis in previously fit individuals is a common condition that is usually mild and self limiting. Chronic bronchitis remains a common cause of morbidity and... (Review)
Review
Acute bronchitis in previously fit individuals is a common condition that is usually mild and self limiting. Chronic bronchitis remains a common cause of morbidity and mortality, and the cost to the nation due to lost working days and to health services is enormous. Cigarette smoking is the major etiologic factor, although exacerbations may be caused by viruses, environmental pollutants, allergic responses, and bacterial infections. New insights into the underlying basic mechanisms of bronchial inflammation are being made. Antibiotics are commonly used to treat exacerbations, although evidence of efficacy is sometimes lacking. Some patients may be prone to recurrent exacerbations and this influences their chance of recovery. Clinical trials must include an assessment of the severity of the exacerbation, and protocols would be improved by increased definition of the type of patient being enrolled and by inclusion of more detailed measures of benefit. Influenza and pneumococcal vaccination should be encouraged in appropriate patients.
Topics: Anti-Bacterial Agents; Bronchitis; Chronic Disease; Humans; Morbidity; Severity of Illness Index; Smoking
PubMed: 9363050
DOI: No ID Found -
Lung Dec 2022Chronic cough is a debilitating condition affecting 10-12% of the general population and is one of the leading causes for referral to secondary care. Many conditions... (Review)
Review
Chronic cough is a debilitating condition affecting 10-12% of the general population and is one of the leading causes for referral to secondary care. Many conditions have been associated with chronic cough, including asthma, gastro-esophageal reflux disease and upper airways cough syndrome. Inflammatory airway conditions including cough variant asthma (CVA) and non-asthmatic eosinophilic bronchitis (NAEB) contribute to a significant proportion of presentations with chronic cough, with differing diagnostic criteria and different responses to commonly used asthma therapy for their respective diagnoses. Mechanistic studies in both animal models and humans have identified increased neuronal sensitivity and subsequent central sensitization. These mechanisms include inflammatory-mediated nociceptor sensitization and alterations of afferent nerve terminal excitability, phenotypic changes in the vagal afferent neurons over time, and central neuroplasticity resulting from increased synaptic signalling from peripheral afferents. The aim of this review is to discuss the mechanisms, neurophysiology, and management approaches currently available for patients presenting with chronic cough with underlying asthma, CVA, and NAEB and to shed a light on areas of further research required to elucidate the mechanisms of cough in this patient population.
Topics: Humans; Animals; Cough; Eosinophilia; Bronchitis; Asthma; Bronchitis, Chronic; Chronic Disease
PubMed: 36227349
DOI: 10.1007/s00408-022-00575-6 -
The New England Journal of Medicine Feb 2022
Topics: Bronchitis; Bronchoscopy; Humans; Lung; Lymphatic Vessels; Male; Middle Aged
PubMed: 35196430
DOI: 10.1056/NEJMicm2111951 -
Pediatric Pulmonology Nov 2023
Topics: Humans; Bronchitis; Bronchoscopy
PubMed: 37750595
DOI: 10.1002/ppul.26707 -
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 -
Tidsskrift For Den Norske Laegeforening... Aug 2017Protracted bacterial bronchitis is a common cause of persistent, wet cough in pre-school children. The condition has been described relatively recently, and knowledge of... (Review)
Review
Protracted bacterial bronchitis is a common cause of persistent, wet cough in pre-school children. The condition has been described relatively recently, and knowledge of the diagnosis may be an aid to making the correct assessment of children with chronic cough, helping to ensure that the symptoms are not misinterpreted and treated as asthma.
Topics: Anti-Bacterial Agents; Bronchitis; Child; Child, Preschool; Cough; Diagnosis, Differential; Humans
PubMed: 28828815
DOI: 10.4045/tidsskr.16.0843 -
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 -
The European Respiratory Journal Mar 1996Plastic bronchitis is generally associated with some type of pulmonary disease and improves either spontaneously or with medical therapy. We present a case of plastic... (Review)
Review
Plastic bronchitis is generally associated with some type of pulmonary disease and improves either spontaneously or with medical therapy. We present a case of plastic bronchitis with no known cause. The patients' symptoms were not responsive to medical therapy but were relieved after right middle lobectomy.
Topics: Adolescent; Bronchitis; Cardiomegaly; Humans; Male; Pneumonectomy; Treatment Failure
PubMed: 8730027
DOI: 10.1183/09031936.96.09030612