Acute bronchitis, an infection causing inflammations of the lung’s airways, is one of the most common of human ailments.
It usually begins with head cold symptoms, such as a runny nose, sinus congestion or a sore throat. It is almost always caused by a virus and rarely by bacteria. If a cough is not caused by pneumonia, influenza or asthma, it is most likely a symptom of bronchitis.
Most people actually feel fairly well with bronchitis, except for having a persistent cough. Fever is rare with bronchitis, and mucus production may or may not be present.
A very common misperception is that colored mucus, especially green, indicates a bacterial infection and therefore the need for antibiotics. Recent scientific evidence overwhelmingly supports that virus infections also produce green mucus, and viruses are treated not with antibiotics, but rather by one’s own immune system.
Those who smoke are much more susceptible to bronchitis, because of the damage done by the smoke to the lining of the breathing tubes; therefore, germs can enter the lungs more easily, causing an infection.
Many patients request antibiotics in hopes of quickly ridding themselves of the cough and therefore visit their doctor as soon as symptoms begin so that they may “nip it in the bud.” Some think that antibiotics helped them on previous occasions, but there is no proven benefit for these drugs in the treatment of bronchitis. Inappropriate antibiotic use can cause unnecessary side effects, increase the cost of medical care and lead to the development of resistant germs.
Treatment for bronchitis should be directed toward relieving the symptoms.
For the head cold symptoms that go with bronchitis, Tylenol (acetaminophen) or Advil (ibuprofen) can be used for the relief of aches and pains. An oral decongestant pill, such as Sudafed (pseudoephrine), as well as a decongestant nasal spray, such as Afrin (oxymetazoline hydrochloride), can be used to combat nasal and sinus congestion. Afrin spray is usually very effective, but it should not be used for more than a week to avoid rebound (worsening) congestion.
Drinking plenty of liquids has proven to be very effective to keep the mucus loose. For cough symptoms, over-the-counter cough medicines with dextromethorphan, such as Robitussin DM or Vicks 44, may be helpful.
If one ends up at the doctor’s office, a prescription cough medication may be prescribed. A cough suppressant, especially if taken at bedtime, will not interfere with the healing process. Also, for a cough associated with wheezing, a doctor may prescribe a brief course of an inhaled medication commonly used for asthmatics.
In summary:
**Bronchitis is caused by a virus, and antibiotics are almost never necessary
**The cough of bronchitis often lasts 10 to 20 days.
**For aches and pains, Tylenol or Advil
**For nasal or sinus congestion, Sudafed or Afrin nasal spray
**For cough relief, Robitussin DM or Vicks 44
See your doctor if you have any significant worries regarding your symptoms, but especially if your cough is associated with a fever of greater than 38 degrees Celsius or 100½ degrees Fahrenheit, or if you have chest pain or trouble breathing.
Terry Hollenbeck, M.D., is an urgent-care physician at the Palo Alto Medical Foundation Santa Cruz in Scotts Valley. A doctor with 36 years’ experience, he invites readers to view his previous columns at his website, Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.

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