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Janusinfo, Sweden: “Do not treat uncomplicated acute bronchitis with antibiotics”

According to Janusinfo and the studies antibiotics have no clinically meaningful effect on acute bronchitis in otherwise healthy lung. In a meta-analysis of 17 randomized trials that compared antibiotics versus placebo was seen on average a shorter time with cough and malaise in half a day.

Cough is one of the most common complaints that patients seeking primary care for. Acute bronchitis or bronchitis is a transient inflammation of the lower airways with cough as the predominant symptom. The cause is almost always a viral infection where the rhinovirus, RS virus and influenza viruses are among the most common.

According to the studies and the guidelines referred below there is no clear boundary between acute bronchitis and upper respiratory tract infection (URTI), but at URTI appear increasingly runny nose, nasal congestion and sore throat. URTI usually lasts no more than two weeks, but the cough in acute bronchitis is difficult and usually keeps itself for three weeks, 10 percent can cough for five to six weeks.

Janusinfo is a non-commercial website providing drug information to support healthcare professionals in their everyday work. Janusinfo’s text is based on these studies and guidelines:

  • Läkemedelsverket. Farmakologisk behandling av nedre luftvägsinfektioner i öppen vård. Behandlingsrekommendation 2008.
  • Smith SM, Fahey T, Smucny J, Becker LA. Antibiotics for acute bronchitis. Cochrane Database Syst Rev. 2014 Mar 1;3:CD000245. PubMed
  • King DE, Williams WC, Bishop L, Shechter A. Effectiveness of erythromycin in the treatment of acute bronchitis. J Fam Pract 1996;42(6):601-5. PubMed
  • Little P, Stuart B, Moore M, Coenen S, Butler CC, Godycki-Cwirko M et al.  Amoxicillin for acute lower-respiratory-tract infection in primary care when pneumonia is not suspected: a 12-country, randomised, placebo-controlled trial. Lancet Infect Dis. 2013 Feb;13(2):123-9. PubMed 

Reference:
Janusinfo. Behandla inte okomplicerad akut bronkit med antibiotika. 19.1.2016.
http://www.janusinfo.se/Behandling/Expertradsutlatanden/Infektionssjukdomar/Behandla-inte-okomplicerad-akut-bronkit-med-antibiotika/

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