Treatment

A. Antibiotics. Physicians often treated acute bronchitis with antibiotics, even though scant evidence exists that antibiotics offer any significant advantage over placebo. Antibiotic therapy is beneficial in patients with exacerbations of chronic bronchitis.

Oral Antibiotic Regimens for Bronchitis

Drug

Recommended regimen

Azithromycin (Zithromax)

Day 1,500 mg; then 250 mg qd

Erythromycin

250-500 mg q6h

Clarithromycin (Biaxin)

500 mg bid

Levofloxacin (Levaquin)

500 mg qd

Sparfloxacin (Zagam)

Day 1,400 mg; then 200 mg qd

Trovafloxacin (Trovan)

200 mg qd

Grepafloxacin (Raxar)

600 mg qd

Trimethoprim/sulfamethoxazole (Bactrim, Septra)

1 DS tablet bid

Doxycycline

100 mg bid

B. Bronchodilators. Significant relief of symptoms occurs with inhaled albuterol (two puffs four times daily). Patients who are treated with inhaled albuterol also return to work sooner. When productive cough and wheezing are present, bronchodilator therapy may be useful.

References: See page 195.

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