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Bronchitis: Should I Take Antibiotics


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Bronchitis: Should I Take Antibiotics?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Bronchitis: Should I Take Antibiotics?

Get the facts

Your options

  • Take antibiotics for acute bronchitis.
  • Don't take antibiotics. Try home treatment instead.

Key points to remember

  • Bronchitis is usually caused by a virus and often follows a cold or flu. Antibiotics usually do not help acute bronchitis, and they may be harmful.
  • Experts recommend that you not use antibiotics to try to relieve symptoms of acute bronchitis if you have no other health problems.
  • Most cases of acute bronchitis go away in 2 to 3 weeks, but some may last 4 weeks. Home treatment to relieve symptoms is usually all that you need.
  • Taking antibiotics too often or when you don't need them can be harmful. Not taking the full course of antibiotics when your doctor prescribes them also can be harmful. The medicine may not work the next time you take it when you really do need it. This is called antibiotic resistance.
  • Antibiotics may help prevent complications from acute bronchitis in people who have other problems, such as chronic obstructive pulmonary disease (COPD), other long-term breathing problems (such as asthma or cystic fibrosis), or heart failure.
FAQs

What is acute bronchitis?

Acute bronchitis means that the tubes that carry air to the lungs (the bronchial tubes) are inflamed and irritated. When this happens, the tubes swell and produce mucus. This makes you cough.

What causes acute bronchitis?

Acute bronchitis is almost always caused by a virus.1 It's more common during the winter months and often develops after an upper respiratory tract infection such as the flu or a cold. Respiratory syncytial virus (RSV) may be a cause, especially in adults older than 65.

Acute bronchitis can also be caused by exposure to smoke, chemicals, or air pollution, all of which can irritate the bronchial tubes. Or it may happen if you accidentally inhale food or vomit.

What are the risks of acute bronchitis?

If you have no other health problems, acute bronchitis poses little risk.

Pneumonia is the most serious problem that can occur. It's most likely to develop if you have a long-term (chronic) disease, such as:

  • COPD.
  • Asthma.
  • Cystic fibrosis.
  • Heart failure.

Treatment for people with these health problems depends on their condition.

How well do antibiotics work to treat acute bronchitis?

If you don't have any other health problems besides acute bronchitis, antibiotics won't be very helpful.

Antibiotics can help shorten the length of time you have a cough, but they may cause side effects and contribute to antibiotic resistance.2

How can you treat acute bronchitis without antibiotics?

Most cases of acute bronchitis go away in 2 to 3 weeks, but some may last 4 weeks. Home treatment to relieve symptoms is usually all that you need. Here are some things you can try that may help you feel better:

  • Relieve your cough by drinking fluids, using cough drops, and avoiding things like smoke that can irritate your lungs.
  • Get enough rest so that your body has the energy it needs to fight the virus. You'll feel better sooner if you rest more than usual while you have acute bronchitis.
  • Try over-the counter medicines such as acetaminophen, ibuprofen, or aspirin to relieve fever and body aches. Do not give aspirin to anyone younger than 20. It has been linked to Reye syndrome, a serious illness. Be safe with medicines. Read and follow all instructions on the label.

Why might your doctor recommend taking antibiotics?

Your doctor may recommend that you take antibiotics for acute bronchitis if:

  • You are at risk for pneumonia.
  • Your condition hasn't gotten better in 14 to 21 days.
  • You have COPD, asthma, cystic fibrosis, or heart failure.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Take antibiotics for acute bronchitis Take antibiotics for acute bronchitis
  • You take the antibiotic medicine as prescribed by your doctor. Don't stop taking it just because you feel better. You'll need to take the full course of antibiotics.
  • Antibiotics may shorten the length of time you have a cough by about a day.
  • Antibiotics may be helpful to treat acute bronchitis if you also have other health problems, such as:
    • COPD.
    • Other long-term breathing problems such as asthma or cystic fibrosis.
    • Heart failure.
  • Antibiotics don't help a night cough or a cough with mucus. And they don't improve your quality of life.
  • Taking antibiotics too often or when you don't need them can be harmful. The antibiotic may not work the next time you take it when you really do need it.
  • Side effects from antibiotics include:
Don't take antibiotics Don't take antibiotics
  • You try home treatment to relieve your cough, such as drinking fluids and using cough drops.
  • You take over-the-counter medicines to relieve fever and body aches.
  • You may reduce your cough with home treatment.
  • You avoid the cost and side effects of antibiotics.
  • You avoid promoting antibiotic-resistant bacteria.
  • If you have acute bronchitis but no other health problems, choosing not to take antibiotics poses no risk.
  • If you have acute bronchitis and other health problems such as COPD, asthma, or heart failure, your risk of getting pneumonia is higher if you don't take antibiotics.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about taking antibiotics for acute bronchitis

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I was diagnosed with acute bronchitis after having the flu. Although I know people who have used antibiotics for this condition, my doctor told me that antibiotics would not be effective for acute bronchitis caused by a viral infection. She suggested I take cough medicine for my cough if necessary. This made sense to me.

Paula, age 26

I have asthma. When I was diagnosed with acute bronchitis, my doctor felt that because of the asthma, and my age, that I was at risk for pneumonia. He suggested a course of antibiotics, and I agreed.

Josef, age 67

When I was diagnosed with acute bronchitis, I thought I'd get some antibiotics and that would be the end of it. My doctor explained that this might shorten my cough by a day but really would do no more. One day is not worth the hassle and cost of antibiotics, so I just used cough medicine.

Theo, age 46

I guess acute bronchitis usually goes away in a couple of weeks, so my doctor suggested I treat my symptoms at home. But it's been about a month and I'm still coughing and feeling bad. We are going to try some antibiotics.

Martha, age 52

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antibiotics

Reasons not to take antibiotics

I'm worried that I might be sick with something other than acute bronchitis.

I just have acute bronchitis.

More important
Equally important
More important

My cough is pretty bad, and I think antibiotics could help me relieve it.

I want to try home treatment to relieve my cough.

More important
Equally important
More important

I'm not worried about the side effects of antibiotics.

I don't want to deal with the side effects of antibiotics.

More important
Equally important
More important

I'm willing to take the risk that antibiotics won't work the next time I really need them.

I don't want to take antibiotics if I don't really need them.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking antibiotics

NOT taking antibiotics

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1.

Will antibiotics help you feel better faster when you have acute bronchitis?

  • YesSorry, that's not right. Antibiotics kill bacteria or slow or stop their growth. But since acute bronchitis is most often caused by a virus and not by bacteria, antibiotics don't work very well to treat it.
  • NoYou're right. Antibiotics kill bacteria or slow or stop their growth. But since acute bronchitis is most often caused by a virus and not by bacteria, antibiotics don't work very well to treat it.
  • I'm not sureIt may help to go back and read "Get the Facts." Antibiotics kill or slow bacteria. But since acute bronchitis is most often caused by a virus, antibiotics aren't the best treatment for it.
2.

Can home treatment relieve most symptoms of acute bronchitis?

  • YesYou're right. Most cases of acute bronchitis go away in 2 to 3 weeks. Home treatment to relieve symptoms is usually all that you need.
  • NoSorry, that's not right. Most cases of acute bronchitis go away in 2 to 3 weeks. Home treatment to relieve symptoms is usually all that you need.
  • I'm not sureIt may help to go back and read "Get the Facts." Most cases of acute bronchitis go away in 2 to 3 weeks. Home treatment to relieve symptoms is usually all that's needed.
3.

Is there anyone who can benefit from taking antibiotics for acute bronchitis?

  • YesYou're right. Antibiotics may help people who have acute bronchitis and other health problems, such as COPD or asthma.
  • NoSorry, that's not right. Antibiotics may be useful in treating people who have acute bronchitis and other health problems, such as COPD or asthma.
  • I'm not sureIt may help to go back and read "Get the Facts." Antibiotics may help people who have acute bronchitis and other health problems, such as COPD or asthma.
4.

Can you take antibiotics as often as you feel you need to and still have them work every time?

  • YesSorry, that's not right. Taking antibiotics too often or when you don't really need them can be harmful. The medicine may not work the next time when you really do need it.
  • NoYou're right. Taking antibiotics too often or when you don't really need them can be harmful. The medicine may not work the next time when you really do need it.
  • I'm not sureIt may help to go back and read "Get the Facts." Taking antibiotics too often or when you don't really need them can be harmful. The medicine may not work the next time when you really do need it.

Decide what's next

1.

Do you understand the options available to you?

2.

Are you clear about which benefits and side effects matter most to you?

3.

Do you have enough support and advice from others to make a choice?

Certainty

1.

How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
3.

Use the following space to list questions, concerns, and next steps.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts

Key concepts that you understood

Key concepts that may need review

Getting ready to act

Patient choices

Credits and References

Credits
CreditsHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerRobert L. Cowie, MB, FCP(SA), MD, MSc, MFOM - Pulmonology

References
Citations
  1. Wenzel RP (2012). Acute bronchitis and tracheitis. In L Goldman, A Shafer, eds.,Goldman's Cecil Medicine, 24th ed., pp. 586–587. Philadelphia: Saunders.
  2. Wark P (2011). Bronchitis, search date March 2010. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Bronchitis: Should I Take Antibiotics?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Take antibiotics for acute bronchitis.
  • Don't take antibiotics. Try home treatment instead.

Key points to remember

  • Bronchitis is usually caused by a virus and often follows a cold or flu. Antibiotics usually do not help acute bronchitis, and they may be harmful.
  • Experts recommend that you not use antibiotics to try to relieve symptoms of acute bronchitis if you have no other health problems.
  • Most cases of acute bronchitis go away in 2 to 3 weeks, but some may last 4 weeks. Home treatment to relieve symptoms is usually all that you need.
  • Taking antibiotics too often or when you don't need them can be harmful. Not taking the full course of antibiotics when your doctor prescribes them also can be harmful. The medicine may not work the next time you take it when you really do need it. This is called antibiotic resistance.
  • Antibiotics may help prevent complications from acute bronchitis in people who have other problems, such as chronic obstructive pulmonary disease (COPD), other long-term breathing problems (such as asthma or cystic fibrosis), or heart failure.
FAQs

What is acute bronchitis?

Acute bronchitis means that the tubes that carry air to the lungs (the bronchial tubes) are inflamed and irritated. When this happens, the tubes swell and produce mucus. This makes you cough.

What causes acute bronchitis?

Acute bronchitis is almost always caused by a virus.1 It's more common during the winter months and often develops after an upper respiratory tract infection such as the flu or a cold. Respiratory syncytial virus (RSV) may be a cause, especially in adults older than 65.

Acute bronchitis can also be caused by exposure to smoke, chemicals, or air pollution, all of which can irritate the bronchial tubes. Or it may happen if you accidentally inhale food or vomit.

What are the risks of acute bronchitis?

If you have no other health problems, acute bronchitis poses little risk.

Pneumonia is the most serious problem that can occur. It's most likely to develop if you have a long-term (chronic) disease, such as:

  • COPD.
  • Asthma.
  • Cystic fibrosis.
  • Heart failure.

Treatment for people with these health problems depends on their condition.

How well do antibiotics work to treat acute bronchitis?

If you don't have any other health problems besides acute bronchitis, antibiotics won't be very helpful.

Antibiotics can help shorten the length of time you have a cough, but they may cause side effects and contribute to antibiotic resistance.2

How can you treat acute bronchitis without antibiotics?

Most cases of acute bronchitis go away in 2 to 3 weeks, but some may last 4 weeks. Home treatment to relieve symptoms is usually all that you need. Here are some things you can try that may help you feel better:

  • Relieve your cough by drinking fluids, using cough drops, and avoiding things like smoke that can irritate your lungs.
  • Get enough rest so that your body has the energy it needs to fight the virus. You'll feel better sooner if you rest more than usual while you have acute bronchitis.
  • Try over-the counter medicines such as acetaminophen, ibuprofen, or aspirin to relieve fever and body aches. Do not give aspirin to anyone younger than 20. It has been linked to Reye syndrome, a serious illness. Be safe with medicines. Read and follow all instructions on the label.

Why might your doctor recommend taking antibiotics?

Your doctor may recommend that you take antibiotics for acute bronchitis if:

  • You are at risk for pneumonia.
  • Your condition hasn't gotten better in 14 to 21 days.
  • You have COPD, asthma, cystic fibrosis, or heart failure.

2. Compare your options

Take antibiotics for acute bronchitis Don't take antibiotics
What is usually involved?
  • You take the antibiotic medicine as prescribed by your doctor. Don't stop taking it just because you feel better. You'll need to take the full course of antibiotics.
  • You try home treatment to relieve your cough, such as drinking fluids and using cough drops.
  • You take over-the-counter medicines to relieve fever and body aches.
What are the benefits?
  • Antibiotics may shorten the length of time you have a cough by about a day.
  • Antibiotics may be helpful to treat acute bronchitis if you also have other health problems, such as:
    • COPD.
    • Other long-term breathing problems such as asthma or cystic fibrosis.
    • Heart failure.
  • You may reduce your cough with home treatment.
  • You avoid the cost and side effects of antibiotics.
  • You avoid promoting antibiotic-resistant bacteria.
What are the risks and side effects?
  • Antibiotics don't help a night cough or a cough with mucus. And they don't improve your quality of life.
  • Taking antibiotics too often or when you don't need them can be harmful. The antibiotic may not work the next time you take it when you really do need it.
  • Side effects from antibiotics include:
    • Diarrhea.
    • Nausea, upset stomach, or vomiting.
    • Sore mouth.
    • Skin rash.
    • Dizziness.
    • Headache.
    • Increased sensitivity to sun.
    • Vaginal yeast infection.
  • If you have acute bronchitis but no other health problems, choosing not to take antibiotics poses no risk.
  • If you have acute bronchitis and other health problems such as COPD, asthma, or heart failure, your risk of getting pneumonia is higher if you don't take antibiotics.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about taking antibiotics for acute bronchitis

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I was diagnosed with acute bronchitis after having the flu. Although I know people who have used antibiotics for this condition, my doctor told me that antibiotics would not be effective for acute bronchitis caused by a viral infection. She suggested I take cough medicine for my cough if necessary. This made sense to me."

— Paula, age 26

"I have asthma. When I was diagnosed with acute bronchitis, my doctor felt that because of the asthma, and my age, that I was at risk for pneumonia. He suggested a course of antibiotics, and I agreed."

— Josef, age 67

"When I was diagnosed with acute bronchitis, I thought I'd get some antibiotics and that would be the end of it. My doctor explained that this might shorten my cough by a day but really would do no more. One day is not worth the hassle and cost of antibiotics, so I just used cough medicine."

— Theo, age 46

"I guess acute bronchitis usually goes away in a couple of weeks, so my doctor suggested I treat my symptoms at home. But it's been about a month and I'm still coughing and feeling bad. We are going to try some antibiotics."

— Martha, age 52

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antibiotics

Reasons not to take antibiotics

I'm worried that I might be sick with something other than acute bronchitis.

I just have acute bronchitis.

More important
Equally important
More important

My cough is pretty bad, and I think antibiotics could help me relieve it.

I want to try home treatment to relieve my cough.

More important
Equally important
More important

I'm not worried about the side effects of antibiotics.

I don't want to deal with the side effects of antibiotics.

More important
Equally important
More important

I'm willing to take the risk that antibiotics won't work the next time I really need them.

I don't want to take antibiotics if I don't really need them.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking antibiotics

NOT taking antibiotics

Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Will antibiotics help you feel better faster when you have acute bronchitis?

  • Yes
  • No
  • I'm not sure
You're right. Antibiotics kill bacteria or slow or stop their growth. But since acute bronchitis is most often caused by a virus and not by bacteria, antibiotics don't work very well to treat it.

2. Can home treatment relieve most symptoms of acute bronchitis?

  • Yes
  • No
  • I'm not sure
You're right. Most cases of acute bronchitis go away in 2 to 3 weeks. Home treatment to relieve symptoms is usually all that you need.

3. Is there anyone who can benefit from taking antibiotics for acute bronchitis?

  • Yes
  • No
  • I'm not sure
You're right. Antibiotics may help people who have acute bronchitis and other health problems, such as COPD or asthma.

4. Can you take antibiotics as often as you feel you need to and still have them work every time?

  • Yes
  • No
  • I'm not sure
You're right. Taking antibiotics too often or when you don't really need them can be harmful. The medicine may not work the next time when you really do need it.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

Credits
ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerRobert L. Cowie, MB, FCP(SA), MD, MSc, MFOM - Pulmonology

References
Citations
  1. Wenzel RP (2012). Acute bronchitis and tracheitis. In L Goldman, A Shafer, eds.,Goldman's Cecil Medicine, 24th ed., pp. 586–587. Philadelphia: Saunders.
  2. Wark P (2011). Bronchitis, search date March 2010. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.

Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

Last Revised: May 15, 2013

Author: Healthwise Staff

Medical Review: E. Gregory Thompson, MD - Internal Medicine & Robert L. Cowie, MB, FCP(SA), MD, MSc, MFOM - Pulmonology


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