Tuesday, June 18, 2024

Do You Need Antibiotics For Bronchitis

Personal Stories About Taking Antibiotics For Acute Bronchitis

Quick Medical Tip: You don’t need antibiotics for bronchitis!

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I was diagnosed with acute bronchitis after having the flu. Although I know people who have used antibiotics for this condition, my doctor told me that antibiotics would not be effective for acute bronchitis caused by a viral infection. She suggested I take cough medicine for my cough if necessary. This made sense to me.

Paula, age 26

I have asthma. When I was diagnosed with acute bronchitis, my doctor felt that because of the asthma, and my age, that I was at risk for pneumonia. He suggested a course of antibiotics, and I agreed.

Josef, age 67

When I was diagnosed with acute bronchitis, I thought I’d get some antibiotics and that would be the end of it. My doctor explained that this might shorten my cough by a day but really would do no more. One day is not worth the hassle and cost of antibiotics, so I just used cough medicine.

Theo, age 46

I guess acute bronchitis usually goes away in a couple of weeks, so my doctor suggested I treat my symptoms at home. But it’s been about a month and I’m still coughing and feeling bad. We are going to try some antibiotics.

Myths & Facts About Bronchitis

A seasonal cold is no big deal. Once or twice a year, your week is thrown into slow motion, and you pack your system full of vitamin C in hopes of a quick recovery. Beyond a few mild symptoms, youre back on your feet in no time. However, if the cold spreads to your lungs and turns into bronchitis, your symptoms may worsen, and your treatment will likely need to change as well.

How Can I Tell If I Need Antibiotics

You might recognize these signs of an infection if youve had one:

  • Pain

  • Nausea and vomiting

  • Muscle aches

But these signs wont tell you if the infection is bacterial, viral, or fungal. If you think you have an infection, youll need to visit a doctor to find out whether or not antibiotics can help treat it.

Sometimes, your doctor can tell an infection is bacterial just by examining you and asking questions about your symptoms. In other cases, they may want to take samples and run tests to find out what type of infection it is.

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Do I Need Antibiotics For A Persistent Cough

There are many reasons why a cough can persist for days and even weeks. Some coughs are caused by infectious diseases and some by noninfectious processes, such as gastroesophageal reflux , asthma, or postnasal drip. However, acute bronchitis is by far the most common cause of a cough that lasts for several days and is unaccompanied by the classic symptoms of an old-fashioned cold, such as head and nasal congestion. So lets say that youve had a cough for several days. Studies show that a majority of health care providers treat their patients who have just this symptom with antibioticsand often broad-spectrum antibiotics. So surely its time for an antibiotic, isnt it?

What Causes Acute Bronchitis

Bronchitis Throat Pain

Acute bronchitis is most often caused by a contagious virus. The same viruses that cause colds can cause acute bronchitis. First, the virus affects your nose, sinuses, and throat. Then the infection travels to the lining of the bronchial tubes. As your body fights the virus, swelling occurs and mucus is produced.

You can catch a virus from breathing it in or by skin contact. You are at higher risk of catching the virus if you have close contact with someone who has a cold or acute bronchitis.

Lesser-known causes of acute bronchitis are:

  • Bacteria or fungal infections.
  • Exposure to irritants, such as smoke, dust, or fumes. You are at greater risk if your bronchial tubes already have damage.
  • GERD , which causes heartburn. You can get acute bronchitis when stomach acid gets into the bronchial tubes.

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Description Of The Intervention

The use of antibiotics in people with acute bronchial infections remains a controversial area in primary healthcare practice . Streptococcus pneumoniae,Haemophilus influenzae, andMoraxella catarrhalis have been isolated from sputum samples in up to 45% of people with acute bronchitis , but their role is difficult to assess due to potential oropharyngeal colonisation in healthy individuals . Unfortunately, there are no clinically useful criteria that accurately help distinguish bacterial from viral bronchial infections, therefore some authors have called for physicians to stop prescribing antibiotics for people with acute bronchitis . Nevertheless, antibiotics are prescribed for 60% to 83% of people who present to physicians with the condition .

What Causes Bronchitis

Acute bronchitis can be caused by a viral or bacterial infection. Its most commonly caused by viruses, such as the influenza virus. Its also possible to have bacterial and viral bronchitis at the same time.

Your doctor may prescribe antibiotics if they suspect you have bacterial bronchitis. These medications may help reduce the amount of time youre contagious, but may not lessen the duration of symptoms, such as a cough. Antibiotics are not helpful for bronchitis caused by viruses.

Chronic bronchitis is often caused by cigarette smoking. It can also be caused by exposure to environmental toxins, such as air pollution or secondhand smoke.

90 percent of all cases of acute bronchitis are caused by viruses, such as the cold or flu, which are contagious. These illnesses have an incubation period of between two to six days. People typically start to become contagious in the hours preceding the initial onset of symptoms and remain contagious until the symptoms go away. The persistent, dry cough that often follows bronchitis is caused by ongoing irritation of the bronchial tubes, not active infection. That means youre unlikely to be contagious during this time.

Chronic bronchitis is not usually contagious. Because you can have chronic and acute bronchitis at the same time, you may pass acute bronchitis to another person if you have both conditions.

Acute bronchitis usually goes away on its own, but you should consult your doctor if you have any of the following symptoms:

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What This Study Adds

General practitioners judged that about four in five adults with acute bronchitis did not definitely need antibiotics on the day they consulted

Antibiotic use was reduced by a quarter in such patients, who received verbal and written information and reassurance in addition to a prescription for antibiotics

Sharing with the patient the uncertainty about the decision to prescribe seems safe and effective

Symptoms Of Chest Infections

ASK UNMC! I have acute bronchitis. Will antibiotics help?

Pneumonia is more common in winter and spring. It can strike suddenly or come on slowly over a few days. The symptoms will depend on your age, the cause and severity of the infection, and any other medical problems you may have. Symptoms include:

  • Fast or difficult breathing
  • Coughing with brown or green-coloured phlegm
  • Fever
  • Blue colour around the lips
  • Stomach pain
  • A child may vomit, have diarrhoea and be irritable or lethargic.

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How Do Antibiotics Work

Antibiotics are prescription-only medications that fight bacteria in one of 2 ways: they either kill bacteria or stop bacteria from growing. Antibiotics dont treat infections caused by viruses or fungi .

Understanding how antibiotics work can be complicated. First, there are many classes of antibiotics: penicillins like , cephalosporins like , aminoglycosides like , and more. And then within each class, individual antibiotics treat different types of infections. , for example, can treat urinary tract infections but can also be used to treat travelers diarrhea and infected wounds.

What Are My Treatment Options For Sinusitis Or Bronchitis

Per new guidance from the CDC, antibiotics are not likely to be necessary or helpful plus, they may harm the good bacteria in our gut which plays a critical role in our immunity as well as regulation of body weight. Most symptoms will clear completely in 2-3 weeks entirely on their own.

Recommended measures for Sinusitis or Bronchitis: lots of fluids, decongestants, mucolytic medications such as Mucinex, and nasal saline rinses or sprays, Neti pots, or steroid sprays such as Budesonide or Fluticasone. If over-the-counter drugs are not helping you, prescription medicines such as cough suppressants, steroids, and inhalers are also available from a doctor, such as online at PlushCare.

Oregano oil in a pot of boiling water and breathing in the steam can help with sinus symptoms, too. Oregano is anti-inflammatory and has antiviral and bacterial properties as well.

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When Do You Really Need Antibiotics For That Sinus Infection

It was February, and clinic was teeming with respiratory infections of all kinds: mostly the common cold, but also bronchitis, pneumonia, and sinus infections. The patients were coming in usually thinking that they needed antibiotics for their sinus infection, or another respiratory infection.The first patient on my schedule was a healthcare provider with sinus infection written down as her main issue.* Shed had about two weeks of nasal and sinus congestion which she blamed on a viral upper respiratory infection . Her two young kids had been sick with colds all winter, so she wasnt surprised to have these symptoms, along with endless postnasal drip and a cough.

Her congestion had improved a bit at one point, and she thought that she was finally getting better. But then, the day before her appointment, she awoke with throbbing pain between her eyes, completely blocked nasal passages, and, more concerning to her, green pus oozing from her left tear duct. She had body aches, chills, and extreme fatigue.

Why Are Antibiotics Not Usually Given For Acute Bronchitis

Do You Get Antibiotics For A Chest Infection

First off, acute bronchitis is often, as we’ve already seen, caused by viruses and irritants causes antibiotics don’t help with at all. The CDC notes that though bacteria can also be behind acute bronchitis, antibiotics aren’t recommended in those cases either, as they will not speed the recovery process along.

There is plenty of research to back this up. A review of studies on the topic of antibiotics and acute bronchitis noted that “some” people diagnosed with acute bronchitis reported faster recovery when given antibiotics. This “faster” amounted to half a day over the course of an illness that lasted eight to 10 days, however, so it was hardly significant. On the other hand, the review also found that people who received antibiotics had more side effects, such as nausea and vomiting, headaches, and skin rashes. The authors concluded that there is no benefit in offering antibiotics to otherwise healthy folks with acute bronchitis, but people who belong to at-risk groups may benefit, something that requires further study to ascertain.

In conclusion, not only will antibiotics usually not help treat your acute bronchitis by prescribing them, your doctor is contributing to a world in which people will once again succumb to infections we have been able to treat easily since the emergence of antibiotics in massive numbers. The fight against antibiotic-resistant infections is on, and its result will have a tremendous impact on all of humanity.

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Bronchitis: Viral Or Bacterial

You probably know that antibiotics do nothing for illnesses caused by viruses. So then why do some doctors so often prescribe antibiotics for viral bronchitis? And, why do other doctors try to talk you out of getting a prescription for an antibiotic therapy?

There is good reason for both approaches. But its important to consider the threat of antibiotic resistance when doling out antibiotics. When doctors prescribe them unnecessarily, and patients demand them when they arent warranted or dont take them as directed it contributes to an already serious problem.

But first, how do you know if you have bronchitis?

Typically, it causes the following symptoms: Cough with fatigue and usually chest pain, poor appetite, and the initial fever, chills or sweats.

How did you catch it? You catch a virus from breathing infected air. Or you may have come in touch an infected surface or person.

Once you inhale bacteria, they penetrate your mucosa rather quickly and enter your bloodstream. There they replicate rapidly and spread throughout your body quickly. Thats why fatigue is the hallmark symptom of a viral infection, and not a localized pain/symptom alone.

After a few days, the skin of your respiratory tree and the associated mucus/sputum that your body produces in an attempt to protect you, may or may not become secondarily infected with bacteria. The bacteria were already there, but morph and grow because of your new sick condition.

Prescribing And Management Strategies For Acute Bronchitis

Most episodes of acute bronchitis resolve on their own, and how to identify those few patients who may benefit from antibiotics is not clear., Prescribing antibiotics for patients with such self limiting conditions can be counterproductive as it reinforces the belief that antibiotics are beneficial and encourages future consultations.,

Providing patients with information and using a delayed prescription have been advanced by the National Prescribing Centre of the NHS and the Standing Medical Advisory Committee of the Departments of Health as strategies for reducing antibiotic use in the community. Open studies of managing uncomplicated respiratory infection in adults and sore throat and otitis media in children in primary careâ have shown that such strategies result in fewer people taking antibiotics. Our study supports this approach for adults with acute bronchitis. There are nearly three million consultations for acute bronchitis annually in England and Wales and an incidence of up to 70 per 1000 for a practice population of previously well adults. Reducing antibiotic use by a quarter would substantially influence antibiotic use in the community, as currently up to three quarters of UK adults who consult with acute bronchitis receive antibiotics, and the figures are even higher in some other European countries.â

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What If I Am Prescribed Antibiotics

If you need antibiotics, take them exactly as prescribed.Talk with your doctor or pharmacist if you have questions. Tell them if you notice any side effects, chiefly diarrhea. That could be C. difficile infection, which needs to be treated!. In some cases, your doctor may give you a prescription for antibiotics, but tell you to wait and see if you feel better before filling it. If you do feel better, don’t fill the prescription and risk the side effects.

What Is The Difference Between Bronchitis And Pneumonia

How long does it take to get over Bronchitis with antibiotics? – Dr. Sanjay Gupta

In terms of symptoms, these two diseases may seem very similar. Both cause cough, fever, fatigue, and a heavy feeling in your chest. Bronchitis can sometimes progress to pneumonia.

Despite similarities, the conditions are different. First, bronchitis involves the bronchial tubes, while pneumonia affects the alveoli, or the air sacs in the lungs. Second, pneumonia symptoms are usually much worse. In addition, pneumonia can be life-threatening, especially in older people and other vulnerable groups.

If your symptoms do not get better in a week or so, it is best to contact your doctor.

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Risk Of Bias In Included Studies

The overall risk of bias is presented graphically in and summarised in .


In general, there was minimal risk of allocation or selection bias: 15 out of 17 studies clearly reported adequate allocation concealment.


In general, there was minimal risk of bias relating to lack of blinding, with 14 out of 17 studies clearly reporting adequate blinding of outcome assessors.

Incomplete outcome data

The majority of studies had adequate completion of outcome data with minimal risk of attrition bias.

Selective reporting

Most trials evaluated several different outcome measures. In some cases, the published reports included detailed data for only those outcomes found to be statistically significant. To minimise this reporting bias, we attempted to obtain additional data from the trial authors five authors provided this information . However, we were still unable to include data from for the outcomes of cough, night cough, or activity limitations at followup, which were reported in the published trial as being not significantly different between groups.

Other potential sources of bias

Antibiotics For Bronchitis: A Widely Used Bad Idea

If you think you need an antibiotic for acute bronchitis, you are wrong, but you are not alone. Antibiotic prescription rates for adults with the common malady remain stubbornly in the 60% to 80% range, despite a long effort to get them down to zero, a new report says.

Acute bronchitis is a cough that lasts up to three weeks, often after a cold or flu. It is almost always caused by viruses. Antibiotics only treat bacteria, and cause more harm than good when used needlessly. They do nothing for coughs caused by viruses, no matter how hacking, mucus-filled or annoying those coughs may be, experts say.

“The awful truth of acute bronchitis is that the cough on average lasts for three weeks and it doesn’t matter if you take an antibiotic or not,” says Jeffrey Linder, a specialist in internal medicine at Brigham and Women’s Hospital, Boston. He is co-author of a research letter published Tuesday in the medical journal JAMA.

The researchers reviewed records of 3,153 visits to doctors’ offices and emergency rooms for acute bronchitis between 1996 and 2010. They included only adults who were otherwise healthy, not those with immune deficiencies, cancer, lung disease or other conditions that might complicate decision-making.

The good news is that for some illnesses, such as children’s ear infections and sore throats, antibiotic prescribing rates are going down, Linder says.

Rest, fluids and humidifiers

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When To See Your Health Care Provider

If youre experiencing a persistent cough, when should you be concerned? There are several situations in which you should seek medical attention:

  • If you have any underlying illness compromising your health, such as heart disease or pulmonary disease.
  • If you feel really awful, are starting to produce a lot of thick phlegm and have a fever, especially if you become short of breath. See your primary care provider right away, as these symptoms may indicate pneumonia.
  • If youve been exposed to pertussis , an antibiotic may shorten its course if you take it within the first few days. It wont help if you take it later than that, although it will lessen the likelihood of your spreading the illness.
  • If the cough just doesnt go awaythere may be something else that needs medical attention.

Whats the difference between bronchitis and pneumonia?

Bronchitis refers to inflammation of the large airways that channel air into your lungs. Bronchitis is caused exclusively by viruses. Pneumonia refers to inflammation of the lungs, involving the air sacs that transfer oxygen to your blood. Its a more serious condition than bronchitis, with many possible causes, including bacterial and viral infections.

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