A look at acute bronchitis

This time of year it seems many folks are plagued with an irritating cough. After suffering countless sleepless nights coughing, many find themselves at the nearest walk-in clinic looking for an antibiotic to provide quick relief. 

What most people do not realize is more often than not bronchitis is merely a complication of a cold. The term bronchitis means inflammation of the bronchial tubes. The bronchial tubes are responsible for delivering air to the lungs and when they become infected and swollen, people can develop an annoying and sometimes lingering cough. The infection is typically caused by the same viral agents that cause the common cold and flu with less than 10 per cent of cases being caused by bacteria.

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As a result, greater than 90 per cent of cases do not require and should not be treated with antibiotics. Antibiotics are not effective against viruses.  Unnecessary use of antibiotics can lead to antibiotic resistance down the road – not to mention dealing with unpleasant side effects from the antibiotic itself. Frequently, by the time a physician is seen, the body has begun to win over the virus and people mistakenly equate their bodies’ immune response and feeling better to the commencement of the prescription for the antibiotic.

Bronchitis can be classified as acute, meaning it does not immediately return after symptoms subside and does not leave any lasting side effects. In chronic bronchitis, the symptoms tend to either return frequently or never completely clear.  Chronic bronchitis is generally linked to other chronic airway diseases such as COPD. If you begin getting regular bouts of bronchitis symptoms, you should be evaluated for other illnesses/disease states and then be considered for antibiotics.

The most pronounced symptom of acute bronchitis is a nagging, persistent cough. While cough symptoms generally resolve on their own in 10-14 days, in some cases the cough may linger up to eight weeks.  The cough may or may not be productive. In the event of a productive cough, the presence of coloured sputum is not a definitive indicator of a bacterial infection as is often believed. Coloured sputum merely indicates that the immune system has directed cells to fight the infection with colour resulting as a by-product of the immune cells’ actions. 

Other symptoms can include wheezing, tachypnea (rapid breathing), respiratory distress and mild fever.

Treatments for viral acute bronchitis include increasing humidity in the environment to help ease/reduce cough and using over-the-counter pain relievers such as acetaminophen or ibuprofen to reduce fever and chest pain from coughing. 

Unfortunately over-the-counter cough suppressants such as dextromethorphan (DM) have little and conflicting evidence to support their effectiveness.  The same applies to guaifenesin, a common over-the-counter expectorant. There is little evidence to suggest it breaks up and loosens phlegm in the chest allowing you to expel it more easily. In some patients, an inhaler may be prescribed to reduce cough symptoms. The most common inhaler used is the bronchodilator salbutamol.  Salbutamol helps to decrease constriction in the airways while reducing wheezing and coughing. 

In the event that symptoms persist longer than three weeks (your fever increases above 38 C), and you have symptoms of tachycardia (heart rate >100 beats per minute) and abnormal breath, you should see a physician to rule out other causes such as pneumonia or other pulmonary diseases.

Unfortunately acute bronchitis is relatively common this time of year as we spend more time indoors and in close contact with other people. Some people, due to weakened immune systems, are more susceptible to viral infections and immune system function can certainly play a role in how quickly you recover.

Our best defense against illness this winter is prevention – getting plenty of rest, healthy eating, regular exercise, not smoking and washing your hands regularly. It will go a long way to reduce our chances of contracting viruses.  In the event you do get sick stay home, rest and allow your immune system a chance to fight. 

Rest not only speeds up recovery time, but staying home also prevents transmission to others. Keep well, spring is coming and soon another cough and cold season will be behind us.


Leanne Swayze
Pharmacy Manager
Heritage Coop Pharmacy


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