Acute bronchitis

Question 1

Features

Answer 1

Cough and sputum (main symptoms)

Wheeze and dyspnoea (fever or haemoptysis uncommon)

Usually viral infection

Can complicate chronic bronchitis usu. due to;

• Haemophilus influenzae
• Streptococcus pneumoniae

Scattered wheezes on auscultation ± fever or haemoptysis (uncommon)

Question 2

Outcome

Answer 2

Improves spontaneously in 4–8 d in healthy patients.

Question 3

Treatment

Answer 3

Symptomatic treatment

Inhaled bronchodilators for airflow limitation

Antibiotics usually not needed, esp. if previously healthy

Use antibiotics if evidence of acute bacterial infection with;

• fever
• purulent sputum

Amoxycillin 500 mg tds for 5 d;

Doxycycline 200 mg stat, then 100 mg/d for 5 d if mycoplasma suspected