This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

It is probably inadvisable to use cough suppressants.

  • Results from 13 randomized controlled trials involving 1914 adults and children with symptoms of cough and productive sputum, or with a physician's diagnosis of acute bronchitis, indicate that antibiotics may have beneficial effects in acute bronchitis; however, some of the benefits are slight and need to be balanced against costs, adverse effects, and negative effects on antibiotic resistance pattern. (1)
  • Use of antibiotics (2):
    • antibiotic little benefit if no co-morbidity
    • consider 7 day delayed antibiotic with advice
    • symptom resolution can take 3 weeks
    • consider immediate antibiotics if > 80yr and ONE of:
      • hospitalisation in past year, oral steroids, diabetic, congestive heart failure
      • OR > 65yrs with 2 of above
  • if antibiotic treatment is initiated
    • on the limited occasions when an antibiotic is indicated, a five-day course of amoxicillin (500mg three times a day), oxytetracycline (250-500mg four times a day) or doxycycline (200mg on the first day, then 100mg daily) is a suitable first choice (doses quoted are for adults) (1,3)

Notes:

  • little evidence to support the use of oral or inhaled beta 2-agonists (e.g. salbutamol) in adults or children with acute cough or bronchitis and no underlying pulmonary disease (3)
    • a Cochrane review found that patients given b2-agonists were more likely to report tremor, shakiness, or nervousness than patients in the control group (3)
  • analgesics and antipyretics may be used where appropriate
  • insufficient evidence to support the use of other over-the-counter cough medicines
  • simplest and cheapest treatment for a cough may be a home remedy such as honey and lemon

Reference:

(1) Smucny J, Fahey T, Becker L, Glazier R. Antibiotics for acute bronchitis. Cochrane Database Syst Rev. 2004 Oct 18;(4):CD000245. doi: 10.1002/14651858.CD000245.pub2. Update in: Cochrane Database Syst Rev. 2014;3:CD000245. PMID: 15494994.

(2) Smith MP, Lown M, Singh S, Ireland B, Hill AT, Linder JA, Irwin RS; CHEST Expert Cough Panel. Acute Cough Due to Acute Bronchitis in Immunocompetent Adult Outpatients: CHEST Expert Panel Report. Chest. 2020 May;157(5):1256-1265. doi: 10.1016/j.chest.2020.

(3) National Institute for Health and Care Excellence. Cough (Acute): Antimicrobial Prescribing. Vol. 2019. www.nice.org.uk/guidance/ng120 (2019).


Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.