Content developed by Clarity Informatics, providers of online solutions to support the nursing community through appraisals and revalidation.
Acute respiratory infections account for 17% of all GP consultations. The annual incidence of acute bronchitis is 44 per 1,000 adult population. It is usually mild and self limiting, but its predominant symptom – cough – is also shared by community-acquired pneumonia (CAP), and it can be difficult to differentiate between the two conditions.
On completion of this module, you should be better able to:
This resource is provided at an intermediate level by Clarity Informatics. Read the article and answer the self-assessment questions, and reflect on what you have learned.
Complete the resource to obtain a certificate to include in your revalidation portfolio. You should record the time spent on this resource in your CPD log.
Acute bronchitis in adults – Diagnosis and management
The common chest infections in primary care are:
Acute bronchitis – acute inflammation of the bronchial tree associated with oedema and mucus production.
Community acquired pneumonia (CAP) – acute infection of the lung parenchyma.
Infective exacerbations of chronic obstructive pulmonary disease (COPD).
Viral infections account for most cases, but
A significant minority are bacterial, for example
Streptococcus pneumoniae or
Cough is the predominant symptom for acute bronchitis and community-acquired pneumonia (CAP).
It can be difficult to differentiate between acute bronchitis and CAP.
If acute bronchitis and cough persist longer than 3 weeks rule out:
For people with chest signs, other conditions to rule out include:
Antibiotics for acute bronchitis?
Consider prescribing antibiotics if the person:
Is systemically very unwell.
Is at high risk of serious complications because of a pre-existing comorbid condition such as heart, lung, kidney, liver or neuromuscular disease, or immunosuppression.
Is older than 65 years of age with two or more of the following, or older than 80 years with one or more of the following:
Why are antibiotics not usually prescribed for acute bronchitis?
FOLLOW UP FOR ACUTE BRONCHITIS
Follow up is not usually required.
Advise the person to seek advice if:
For people with a pre-existing condition that has deteriorated on treatment, consider:
Alberta Medical Association. The management of acute bronchitis, 2008 Alberta Medical Association. www.topalbertadoctors.org [Free Full Text]
Braman SS. Chronic cough due to acute bronchitis: ACCP evidence-based clinical practice guidelines. Chest 2006; 129(Suppl. 1): 95S-103S. [Abstract]
Macfarlane J, Holmes W, Gard P, et al. Prospective study of the incidence, aetiology and outcome of adult lower respiratory tract illness in the community. Thorax 2001 56(2), 109-114. [Abstract] [Free Full Text]
Morice AH, McGarvey L, Pavord I. (2006) Recommendations for the management of cough in adults. Thorax 2006; 61(Suppl 1):i1-i24. [Free Full Text]
NICE CG69. (2008a) Respiratory tract infections: antibiotic prescribing. Prescribing of antibiotics for self-limiting respiratory tract infections in adults and children in primary care, 2008. [Free Full Text]