Management of Acute Bronchitis in Adults: Recent Trends and Practices

Abstract

Acute bronchitis is a transient upper respiratory tract inflammation. It is one of the most commonly occurring illnesses in ambulatory care and the most frequently encountered diagnosis by primary care physicians. It is a self-limiting disease however it encompasses a wide range of symptoms pertaining to upper respiratory tract that last for at least 2 to 3 weeks. Acute bronchitis does not have a treatment regime and the symptoms are managed conservatively. The purpose of this review is to discuss the management of acute bronchitis, current trends and practices in daily practice. A robust literature search was done on various electronic databases and a wide variety of studies were retrieved which included a multitude of small and large scale randomized clinical, placebo-controlled trials, systematic reviews and clinical practice guidelines were retrieved. Some of the commonly used medicines for symptomatic management of acute bronchitis are antitussive agents, protussive agents, bronchodilator therapy and alternative therapy. Clinical practice guidelines state there is no significant role of antibiotics in acute bronchitis as it does not improve or reduce the duration of symptoms in patients. Furthermore, it is associated with a wide array of adverse effects, antibiotic resistance and leads to inflated health care costs. Despite strict recommendations, antibiotics are highly prescribed by physicians for acute bronchitis based on patient factors such as protracted symptoms, diagnostic uncertainty, possibility of ensuing pneumonia and to meet patient expectations. Physicians should play a key role in educating patients about the course of the disease, raising their awareness on the timeline of symptoms, offer reassurance, informing them on the lack of added benefits of antibiotics and suggesting alternative therapies thereby reducing unwarranted prescriptions in the best interests of the patient