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.