- 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 years old with 2 or more of OR people over 80 years old 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.
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