Medicines for Acute bronchitis

What it is

Acute bronchitis is a short-lived infection of the large airways (the bronchi) that causes them to become inflamed. It usually follows a common cold or other upper-respiratory virus and is, in the great majority of cases, viral and self-limiting — meaning it gets better on its own. The main symptom is a cough, which is often dry at first and may then bring up clear, yellow or green phlegm; the colour of phlegm does not reliably tell you whether antibiotics are needed. Some people also have wheeze, a tight or uncomfortable chest, a mild fever, a sore throat or a blocked nose. The cough is typically the last symptom to settle and can linger for up to about three weeks, sometimes a little longer, even after the person otherwise feels well. Acute bronchitis is different from pneumonia, which is an infection of the lung tissue itself and tends to cause more obvious breathlessness, higher fever and feeling much more unwell; it is also different from a flare-up of an ongoing condition such as asthma or COPD. Most people recover fully without any specific treatment.

How it is treated

For most people, acute bronchitis does not need antibiotics, because it is usually caused by a virus and antibiotics do not help most people, do not shorten the illness meaningfully, and carry side effects and contribute to antibiotic resistance. This is an important point of antimicrobial stewardship: avoiding unnecessary antibiotics protects both the individual and the wider community. Care is therefore supportive — the body clears the infection itself, and the aim is to ease symptoms while that happens. Rest and plenty of fluids help, and simple remedies such as paracetamol or ibuprofen can be used for fever, aches and discomfort. Honey or over-the-counter cough preparations may soothe a troublesome cough, and a pharmacist can advise. People are reassured that the cough can last a few weeks and is part of normal recovery. Antibiotics are reserved for the minority who are frail, who have significant other health problems that put them at higher risk, or where there are signs that the infection has progressed to pneumonia. A doctor may sometimes give a back-up (delayed) prescription, to be used only if symptoms worsen or do not start to improve. Anyone who is becoming more breathless, more unwell, or whose cough is not settling is reassessed to make sure something more serious is not being missed.