Overall Completeness And Applicability Of Evidence
In general, the available evidence suggests we should not be using antibiotics to treat acute bronchitis or lower respiratory tract infections when pneumonia is not expected. There is a modest benefit from antibiotics for some outcomes, but these are of minimal clinical significance. Any benefit is even less apparent in the sensitivity analysis, which included data from subgroups of patients with productive cough of short duration in conjunction with the common cold. Of the two trials in the primary analysis that limited enrolment to people who had been ill for less than one week, one did not show any benefit from antibiotics , whilst the other showed modest benefit from antibiotics .
What Is Chronic Bronchitis
Bronchitis is an inflammation of the airways in the lungs. Chronic means it lasts longer than 3 months. Airways are the tubes in your lungs that air passes through. They are also called bronchial tubes. When the airways are irritated, thick mucus forms in them. The mucus plugs up the airways and makes it hard for air to get into your lungs. That makes it hard to breathe.
Bronchitis also causes a cough that produces mucus and a feeling of tightness in your chest.
Chronic bronchitis is one type of chronic obstructive pulmonary disease , and often occurs with emphysema.
When I see patients with chest colds, they usually dont need antibiotics. Instead, I tell them about some simple treatments they can do at home. Read More
Questions To Ask Your Doctor
- How do I know whats causing my chronic bronchitis?
- What health risks are associated with chronic bronchitis?
- Am I at risk for emphysema or chronic obstructive pulmonary disease ?
- What medicines will help relieve my symptoms?
- What lifestyle changes should I make at home to help relieve my symptoms?
- Is it safe for me to exercise? What kind of exercise should I do?
- What vaccines do I need?
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Can Acute Bronchitis Be Prevented Or Avoided
You can help prevent acute bronchitis by staying healthy and avoiding germs. Wash your hands with soap often to kill any contagious viruses.
If you smoke, the best defense against acute bronchitis is to quit. Smoking damages your bronchial tubes and puts you at risk for infection. Smoking also slows down the healing process.
Other steps you can take to avoid acute bronchitis include:
- Wear a mask over your nose and mouth when using lung irritants. These could include paint, paint remover, or varnish.
- Ask your doctor if you should get a pneumonia shot, especially if you are over age 60.
Why Does Bronchitis Occur
Acute bronchitis is sometimes referred to as a chest cold. It can develop after an upper respiratory infection , which you probably know better as the common cold.
Bronchitis occurs when the airways that carry air to your lungs, called the bronchial tubes, become inflamed and irritated. Your bronchial tubes produce excess mucus and cause coughing when they become inflamed.
Usually acute bronchitis is not serious. If it isnt treated properly it can develop into pneumonia.
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What Is The Difference Between Bronchitis And Pneumonia
While bronchitis is usually caused by a virus and inflames the bronchi which fill with mucus, pneumonia does not affect the upper airways but directly to the alveoli of the lungs.
Pneumonia can be caused by more than 30 viruses, bacteria, and fungi.
Oxygen and CO2 no longer circulate so easily through the bloodstream.
The alveoli swell and fill with fluid.
Symptoms of pneumonia translate into:
- cough
- an increased heart rate
Summary Of Main Results
We found mixed results across studies, with some suggesting marginal benefits for antibiotics, which are however of doubtful clinical significance. The inclusion of the largest multicentre study of the effectiveness of antibiotics in people with lower respiratory tract infections strengthens the evidence and also highlights a statistically significant increase in adverse events in the antibiotictreated groups. However, it is possible that older patients with multimorbidity may not have been recruited to trials, so the evidence guiding decisionmaking in this group of patients is less certain.
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Living With Acute Bronchitis
Most cases of acute bronchitis go away on their own in 7 to 10 days. You should call your doctor if:
- You continue to wheeze and cough for more than 2 weeks, especially at night when you lie down or when you are active.
- You continue to cough for more than 2 weeks and have a bad-tasting fluid come up into your mouth. This may mean you have GERD. This is a condition in which stomach acid gets into your esophagus.
- Your cough produces blood, you feel weak, you have an ongoing high fever, and you are short of breath. These symptoms may mean you have pneumonia.
The risk of developing complications from acute bronchitis, such as pneumonia, is greater in some people. These include:
- Young children
When To See A Doctor
If you have been sick with what seems like a cold or the flu without improvement for 5-7 days, check in with your doctor.
This could be a sign that you have pneumonia or have developed a secondary infection.
If you have a compromised immune system, are over age 65, or have other medical problems, call your doctor sooner.
Children who have symptoms of pneumonia should be seen by their pediatrician right away, since they may not display common signs of pneumonia, even if they are very ill.
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Can Chronic Bronchitis Be Prevented Or Avoided
If you smoke, the most important thing you can do is to stop. The more smoke you breathe in, the more it damages your lungs. If you stop smoking, youll breathe better, you wont cough as much, and your lungs will begin to heal. Youll also reduce your chance of getting lung cancer. Ask your doctor to help you stop smoking.
Try to avoid other things that can irritate your lungs, such as aerosol products like hairspray, spray deodorant, and spray paint. Also avoid breathing in dust or chemical fumes. To protect your lungs, wear a mask over your nose and mouth if you are using paint, paint remover, varnish, or anything else with strong fumes.
What Is The Best Treatment For Acute Bronchitis
Catherine Joyce, MD, Frank J. Domino, MDFamily Practice Recertification
Efficacy of anti-inflammatory or antibiotic treatment in patients with non-complicated acute bronchitis and discoloured sputum: randomised placebo controlled trial
Review
Carl Llor Ana Moragas Carolina Bayona Rosa Morros, Helena Pera, Oleguer Plana-Ripoll, Josep M Cots, Marc Miravitlles. BMJ 2013 347:f5762
Methods
The study was prospective, parallel group, single blinded, placebo controlled study by 25 general practitioners in Catalonia, Spain from April 2010 to January 2012. Patients diagnosed with acute bronchitis were randomized into one of 3 treatment arms .
Although the pills for each treatment were not identical, they were sealed in identical containers before being given to investigators and remained sealed until distributed to patients. Patients were blinded to their treatment allocation. Symptoms were evaluated with patients daily symptom journal and at 2 follow up appointments at 2-4 days and 11-13 days . Pill counts were conducted at follow up and if appropriate pill counts were not returned, compliance was considered insufficient.
Patient Demographics
The average age of patients was 45.1 . 44% were men. Smoking and rates of diabetes were comparable between treatment arms with 37-40% represented by current smokers and 4-12% by diabetics.
Intervention
Outcomes & Main Results
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How Your Healthcare Provider Chooses
Your healthcare provider will only prescribe antibiotics for bronchitis if they think bacteria are causing your symptoms and youre at high risk of the infection not resolving on its own.
If a virus causes your bronchitis, they wont give you antibiotics because the antibiotics wouldnt do anything. If youre young and generally healthy, they probably wont prescribe anything either.
A Cochrane report last updated in 2017 found little evidence that antibiotics help acute bronchitis in healthy people, but recommended further study for patients that are elderly, frail, or have other conditions that may make bronchitis worse.
When considering treatment, your healthcare provider will look at:
- If youve had an allergic reaction to an antibiotic in the past
- Other health conditions, like autoimmune diseases, heart conditions, and lung conditions like asthma or chronic obstructive pulmonary disease
- Your history with smoking or vaping
- The oxygen levels in your blood
If your practitioner decides to prescribe an antibiotic, the treatment they choose will be based on your medical history, personal details, symptoms, diagnosis, and test results.
What To Do If You Have Bronchitis
Do you have shortness of breath, difficulty in breathing, persistent cough, greenish discharge, fatigue, body aches, and a little fever?
Of course, youre not the only one in this case.
Respiratory infections like bronchitis are common and often develop with or after a cold or the flu.
Symptoms can be severe, but most of the time bronchitis goes away on its own.
So lets see what are the symptoms of bronchitis, what are its causes, and how to get rid of it both medically and naturally
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Following A Healthful Diet
To alleviate symptoms of bronchitis and manage the condition, the National Heart, Lung, and Blood Institute recommend lifestyle changes that include following a healthful diet.
A healthful diet consists of fruits, vegetables, and whole grains as well as lean meats, poultry, fish, beans, eggs, and nuts. It also includes fat-free or low-fat dairy products and limits saturated and trans fats, cholesterol, salt, and added sugars.
Eating a healthful diet keeps a persons immune system working. Not eating a balanced diet can lead to a persons immune functions being impaired. This damage is caused by an insufficient intake of energy and macronutrients, as well as a lack of specific micronutrients.
How Effective Are Herbal Products
Various herbal products are available for the treatment of acute . Some of them are based on combinations of different active ingredients. Examples include Pelargonium, primrose, thyme, eucalyptus and ivy extracts. Studies on these products suggest that they can somewhat soothe acute bronchitis coughs and make it easier to cough up phlegm. The possible side effects include stomach and bowel problems. Statutory health insurers in Germany generally dont cover the costs of these products.
Other herbal products such as those used in traditional Chinese medicine have hardly been tested in high-quality studies. So it isnt known whether they can help. But they, too, can have side effects.
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Risk Of Bias In Included Studies
The overall risk of bias is presented graphically in and summarised in .
Allocation
In general, there was minimal risk of allocation or selection bias: 15 out of 17 studies clearly reported adequate allocation concealment.
Blinding
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
Diagnosis Of Acute Bronchitis
When you see your doctor, be ready to talk about your symptoms in detail. You should be able to answer:
- How long have you had your cough?
- Are you coughing up mucus?
- Is there blood in your sputum?
- Did you ever have a fever or other symptoms, such as chest tightness?
- Did you have a cold before the cough?
- Do you have trouble catching your breath?
- Have you been around other people who have the same kinds of symptoms?
At the appointment, your doctor will go over your symptoms and give you a physical exam. Theyâll listen to your chest while you cough. This may be enough to make a diagnosis. You may not need any tests. However, there are other times when you might need one or more.
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Data Collection And Analysis
Selection of studies
One review author evaluated the titles and abstracts of the identified citations and applied the inclusion criteria. We obtained the full papers of trials deemed potentially relevant for further examination. Two review authors screened the fulltext papers to determine if they met the inclusion criteria. We discarded reports that were clearly irrelevant. We recorded studies that did not fulfil the inclusion criteria along with the reasons for their exclusion in the table..
Data extraction and management
Two or more review authors independently extracted data using a data collection form designed for this review. Any disagreements were resolved by discussion between the review authors. We transferred data into Review Manager 5 .
Assessment of risk of bias in included studies
Two review authors evaluated the methodological quality of each trial using Risk of Bias domains recommended in the Cochrane Handook as outlined in and . Disagreements were resolved by consensus.
‘Risk of bias’ graph: review authors’ judgements about each methodological quality item presented as percentages across all included studies.
Measures of treatment effect
The effect measures of choice were risk ratio for categorical outcomes and mean difference for continuous data.
Unit of analysis issues
Dealing with missing data
Assessment of heterogeneity
Analysis
Assessment of reporting biases
Data synthesis
GRADE and ‘Summary of findings’ table
Sensitivity analysis
How To Cure Bronchitis Quickly
Bronchitis can be very exhausting.
Of course, it generates fatigue linked to the infectious state, but its cough is painful.
If we know its not that bad most of the time, its still a good idea to try to relieve it by reducing its symptoms.
Certain natural remedies can give you real support while reducing the duration of the infection.
A load of vitamins leads to a more efficient immune system at killing bacteria and viruses as well.
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Which Medications Can Help Relieve Other Symptoms
Especially in the early stage of acute , other symptoms like headaches, a sore throat, an earache or joint pain may be caused by the cold or flu viruses. These symptoms can then be treated using pain-relieving and fever-lowering medication such as acetaminophen or non-steroidal .
Acetaminophen and NSAIDs, which include ibuprofen and acetylsalicylic acid , are available from pharmacies without a prescription. They come in the form of tablets, suppositories and syrups. Acetylsalicylic acid isnt suitable for children under the age of twelve who have a viral infection with a fever. This is because it can lead to severe brain and liver damage , although that is rare.
What About Antibiotics
Antibiotics are powerful medicines that treat bacterial infections. But acute bronchitis is usually caused by a viral infection. Antibiotics donât help with a virus.
If your doctor thinks the cause is bacteria, you might get a prescription for antibiotics.
If so, be sure to take the full prescription of antibiotics. Even if you feel better, the infection could still be in your system. You want to make sure you kill all the bacteria on the first try.
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What Is Bronchitis
Anyone can get bronchitis, depending on which type it is. Here are the two most common kinds of bronchitis that you or your loved ones can get infected with.
Acute bronchitis
Acute bronchitis usually starts with a cold. It is caused by the same types of viruses that cause a common cold or flu. These include rhinovirus and influenza A and B.
Acute bronchitis can also be caused by bacteria, but that is much rarer. It occurs in less than 10% of cases of acute bronchitis.
If you have bronchitis, you may have any of the following symptoms:
- Coughing with mucus
- Wheezing
When acute bronchitis isnt treated properly it could transform into pneumonia.
Unlike bronchitis, which affects the airways that lead to your lungs, pneumonia affects your alveoli. These are the air sacs inside of your lungs that process oxygen.
Pneumonia is much worse than bronchitis. It can be life-threatening in infants, older people, and other people with weakened immune systems.
There is another type of bronchitis called chronic bronchitis.
Chronic bronchitis is caused by the irritation of your airways. This is usually from smoking or your exposure to other irritants such as toxic gasses.
Chronic bronchitis is actually a type of chronic obstructive pulmonary disease . COPD can cause airflow blockage and breathing problems.
Symptoms of chronic bronchitis can include:
How To Feel Better
Below are some ways you can feel better while your body fights off acute bronchitis:
- Get plenty of rest.
- Use a clean humidifier or cool mist vaporizer.
- Use saline nasal spray or drops to relieve a stuffy nose.
- For young children, use a rubber suction bulb to clear mucus.
Ask your doctor or pharmacist about over-the-counter medicines that can help you feel better. Always use over-the-counter medicines as directed. Remember, over-the-counter medicines may provide temporary relief of symptoms, but they will not cure your illness.
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