Cough is typically worse at night or with exercise; lasts >2 weeks in 50% and 4 weeks in 25% of patients; may be associated with bronchospasm and/or excessive mucus production.
Diagnosis is primarily clinical. Other causes for acute cough such as pneumonia, asthma, or postnasal drip should be ruled out if suspected.
Treatment is aimed at symptom reduction until infection is resolved and bronchial damage repaired. Antibiotics are not recommended in the majority of patients.
Complications are rare; the primary complication is a postbronchitis syndrome, which can produce a cough lasting several months.
Acute bronchitis is defined as a self-limiting lower respiratory tract infection, to distinguish this condition from common colds and other upper respiratory ailments. Bronchitis refers specifically to infections causing inflammation in the bronchial airways, whereas pneumonia denotes infection in the lung parenchyma resulting in consolidation of the affected segment or lobe.
Although there is no universally accepted definition for acute bronchitis, the criteria proposed by MacFarlane offer a practical approach: (a) an acute illness of <21 days; (b) cough as the predominant symptom; (c) at least 1 other lower respiratory tract symptom, such as sputum production, wheezing, chest pain; (d) no alternative explanation for the symptoms. While the MacFarlane criteria state that the symptoms usually last <3 weeks, other studies have shown that cough may linger for >30 days in about a quarter of patients with acute bronchitis. Consequently, acute bronchitis can still be present in patients with coughs lasting >1 month.
This topic focuses on acute bronchitis in adults.
History and exam
Senior Associate Dean for Academic Affairs
Professor of Family and Community Medicine
Medical College of Wisconsin
WJH receives an honorarium for speaking at a board review course sponsored by the American Physicians' Institute on the subject of respiratory diseases, including acute bronchitis. He is also the author of a number of references cited in this monograph.
Dr William J. Hueston would like to gratefully acknowledge Dr Ann M. Rodden, a previous contributor to this monograph. AMR declares that she has no competing interests.
School of Medicine and Public Health
University of Wisconsin-Madison
DLH declares that he has no competing interests.
CR declares that she has no competing interests.
Honorary Senior Lecturer
Imperial College Healthcare Trust
PWI declares that he has no competing interests.
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