Acute cough and bronchitis

Notes

  • Bronchitis causes a cough, breathlessness, wheeze, and general malaise.
  • Crackles on auscultation should clear with coughing - persisting crackles are suggestive of pneumonia.
  • The cough can persist for up to 4 weeks. Viral infections are the cause of >90% of episodes. As the majority of cases are viral infections, routine sputum sampling is not recommended.

Antibiotics are not indicated unless the patient has any of the following risk factors for complications: 

  • pre-existing pulmonary disease
  • people over 65 with 2 or more of OR people over 80 with 1 or more of: hospitalisation in previous year, type 1 or 2 diabetes, history of congestive heart failure, current use of oral corticosteroids.

If it is felt safe not to prescribe antibiotics immediately, consider a delayed antibiotic prescription to be used if a significant worsening of symptoms occurs.

If antimicrobials are required, treat as mild CAP.