Bronchitis - acute

Acute bronchitis involves inflammation of the bronchi causing acute onset of cough, sputum production, and sx of URI.

Etiology: viral agents (coronavirus, rhinovirus, influenza, or parainfluenza). Uncommon causes include Mycoplasma pneumoniae, Chlamydophila pneumonia, and Bordetella pertusis.

Dx: made clinically. Pneumonia should be ruled out either clinically or radiographically, and dxtic test for influenza should be performed if it is suspected. Cough that lasts for >2 weeks in an adult should be evaluated for pertussis with a nasopharyngeal swab for culture or PCR.

Tx: Is symptomatic and is directed most often at controlling cough (dextromethorphan, 15 mg PO q6h). Routine antimicrobial use is not recommended unless pertussis is confirmed.

• • Pertussis. Tx with clarithromycin, 500 mg PO bid x 14 days or azithromycin, 500 mg PO x 1 dose, followed by 250 mg PO daily x 4 days.

  • Pertussis cases should be reported to the local health department for contact tracing and administration of postexposure prophylaxis with azithromycin when indicated.