- Acute bronchitis is a common clinical condition characterized by an acute onset but persistent cough, with or without sputum production. It is typically self-limited, resolving within 1 to 3 weeks. Symptoms result from inflammation of the lower respiratory tract and are most frequently due to viral infection.
- Treatment is focused on patient education and supportive care. Antibiotics are not needed for the great majority of patients with acute bronchitis but are greatly overused for this condition. Reducing antibiotic use for acute bronchitis is a national and international health care priority.
- Acute bronchitis is a lower respiratory tract infection that causes reversible bronchial inflammation, involving the large airways, without evidence of pneumonia.
- Cough, the predominant symptom, may last as long as 3 weeks (1).
- Generally self-limited, with complete healing and full return of function (1)
- Most infections are viral if no underlying cardiopulmonary disease is present (1).
- Synonym(s): tracheobronchitis
Can be serious, particularly if part of influenza, with underlying COPD or CHF
- Usually occurs in association with other conditions of upper and lower respiratory tract (trachea usually involved)
- If repeated attacks occur, child should be evaluated for anomalies of the respiratory tract, immune deficiencies, or for asthma.
- Acute bronchitis caused by RSV may be fatal.
- Antitussive medication not indicated in patients age <6 years (1)
- Predominant age: all ages
- Predominant gender: male = female
It accounts for approximately 10% of ambulatory care visits in the United States, or 100 million visits per year. The incidence of acute bronchitis is highest in late fall and winter when transmission of respiratory viruses peaks (1),(2).
Etiology and Pathophysiology
- Viruses are the most commonly identified pathogens in patients with acute bronchitis (about 60%). The most common viral causes of acute bronchitis include (1):
- Influenza A and B
- Coronavirus types 1 to 3
- Respiratory syncytial virus
- Human metapneumovirus
- Bacteria are detected in 1–10% of cases of acute bronchitis.
- Atypical bacteria, such as Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Bordetella pertussis, are rare causes of acute bronchitis.
- Approximately 10% of patients presenting with a cough lasting at least 2 weeks have evidence of B. pertussis infection.
- Possible fungal infections
- Chemical irritants
- Acute bronchitis causes an injury to the epithelial surfaces, resulting in an increase in mucus production and thickening of the bronchiole wall.
No known genetic pattern
- Air pollutants
- Secondhand smoke
- Environmental changes
- Chronic bronchopulmonary diseases
- Chronic sinusitis
- Tracheostomy or endobronchial intubation
- Bronchopulmonary allergy
- Hypertrophied tonsils and adenoids in children
- Immunoglobulin deficiency
- HIV infection
- Gastroesophageal reflux disease (GERD)
- Avoid smoking and secondhand smoke.
- Control underlying risk factors (i.e., asthma, sinusitis, and reflux).
- Avoid exposure, especially daycare.
- Pneumovax, influenza immunization
Commonly Associated Conditions
- Allergic rhinitis
- Epiglottitis (rare but can be rapidly fatal)
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Domino, Frank J., et al., editors. "Bronchitis, Acute." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116095/all/Bronchitis__Acute.
Bronchitis, Acute. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116095/all/Bronchitis__Acute. Accessed June 3, 2023.
Bronchitis, Acute. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116095/all/Bronchitis__Acute
Bronchitis, Acute [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 June 03]. Available from: https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116095/all/Bronchitis__Acute.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Bronchitis, Acute ID - 116095 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116095/all/Bronchitis__Acute PB - Wolters Kluwer ET - 27 DB - 5-Minute Clinical Consult DP - Unbound Medicine ER -