Treatment aims

Bronchitis treatment involves several basic goals that include:-

• Ruling out other conditions that could affect the lungs (e.g. chronic obstructive pulmonary disease, asthma) and the heart (e.g. heart failure) and treating them individually
• Relieving symptoms of cough, breathlessness etc.
• Treating the infection causing acute bronchitis
• Reducing the risk of chronic bronchitis development
• Reducing the risk of secondary lung infections like pneumonia
• Preventing or halting progression of lung damage especially due to chronic bronchitis.

Treatment of bronchitis

• Most cases of bronchitis, especially the acute type, are caused by viruses and these do not need specific antibiotic treatment. The treatment advised is plenty of fluids and bed rest until the condition resolves. Headaches, fever, blocked and runny nose maybe treated symptomatically using paracetamol or ibuprofen. Ibuprofen is not recommended however for asthma patients.
• There is no cure for chronic bronchitis as well but several measures may be taken to prevent the progression of this condition. Chronic bronchitis is treated in the same way as chronic obstructive pulmonary disease (COPD).
• Cough medications are seldom effective. The Medicines and Healthcare products Regulatory Agency (MHRA) has recommended that over-the-counter (OTC) cough medicines should not be given to children under the age of six. Home remedies for cough and sore throat may be tried. This includes a mixture of honey and lemon.
• Smoking cessation is one of the most important steps to prevent recurrent attacks of bronchitis, chronic bronchitis, complications of bronchitis like pneumonia and COPD.
• Antibiotic treatment is usually not necessary unless there is evidence of infection with bacteria. In most cases the cause of acute bronchitis is viral and antibiotics are ineffective. Antibiotics are prescribed in some special situations that include:-
  • Very small and premature infants
  • Elderly over the age of 80 years
  • Those with underlying heart or lung diseases
  • Those with a weak immune system who are susceptible to secondary infections
  • Patients with cystic fibrosis

  Commonly prescribed antibiotics include a five-day course of amoxicillin, oxytetracycline or doxycycline.

• Mucolytics or mucus thinners – these are prescribed in chronic bronchitis. These thinners make the mucus loose and easy to cough up. Cough suppressants are usually not recommended. These can be advised only if cough is creating significant discomfort. There are several antitussives like hydrocodone, dextromethorphan, codeine etc.
• Pulmonary rehabilitation – this is an exercise program that helps patients with chronic bronchitis and COPD in improving breathing efficiency.
• Bronchodilators – these are agents that increase the diameter of the airways and facilitate breathing. Acute bronchitis patients may not require these agents. However, chronic bronchitis patients benefit from these agents. Short acting agents include Salbutamol, Terbutaline etc. Long acting agents include Salmeterol and Formoterol.