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Bronchitis is one of the top conditions for which patients seek medical care. It is
characterized by inflammation of the bronchial tubes (or bronchi), the air passages that
extend from the trachea into the small airways and alveoli.
When a stable patient experiences sudden clinical deterioration with increased sputum
volume, sputum purulence, and/or worsening of shortness of breath, this is referred to as an
acute exacerbation of chronic bronchitis, as long as conditions other than acute
tracheobronchitis are ruled out.
Allergens and irritants can produce a similar clinical picture. Asthma can be
mistakenly diagnosed as acute bronchitis if the patient has no prior history of asthma. In one
study, one third of patients who had been determined to have recurrent bouts of acute
bronchitis were eventually identified as having asthma. Generally, bronchitis is a diagnosis
made by exclusion of other conditions such as sinusitis, pharyngitis, tonsillitis, and
pneumonia.1
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Intoduction
1. Definition
2. Etiology
Air pollution levels have been associated with increased respiratory health
problems among people living in affected areas. The Air Pollution and Respiratory
Health Branch of the National Center for Environmental Health directs the fight of the
US Centers for Disease Control and Prevention against respiratory illness associated
with air pollution.
The physical examination findings in acute bronchitis can vary from normal-
to-pharyngeal erythema, localized lymphadenopathy, and rhinorrhea to coarse rhonchi
and wheezes that change in location and intensity after a deep and productive cough.
Obtain a throat swab. Culture and gram stain of sputum is often performed,
though these tests usually show no growth or only normal respiratory florae.Blood
culture may be helpful if bacterial superinfection is suspected.
b) Chest Radiography
c) Bronchoscopy
6. Medication Summary
Reviews have also noted that antibiotic use in smokers without chronic
obstructive pulmonary disease is no more effective than use in nonsmokers.
a) Antimicrobials
Erythromycin
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Tetracycline
Trimethoprim-sulfamethoxazole
Amoxicillin
Levofloxacin
Doxycycline
concentrations.
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b) Antitussives/expectorants
This agent treats minor cough resulting from bronchial and throat irritation.
Codeine/guaifenesin
The prototype antitussive, codeine, has been used successfully in some chronic
cough and induced-cough models, but scant clinical data exist for upper respiratory
tract infections.
c) Bronchodilators
Metaproterenol sulfate
Theophylline
Ipratropium
Prednisolone
Prednisone
e) Corticosteroids, Inhaled
Fluticasone
Budesonide
f) Antiviral Agents
Zanamivir
Rimantadine
Oseltamivir
g) Analgesics/antipyretics
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Ibuprofen
Acetaminophen
7. Complications
Bacterial superinfection
Pneumonia develops in about 5% of patients with bronchitis (incidence of subsequent
pneumonia, unaffected by antibiotic treatment)
Chronic bronchitis may develop with repeated episodes of acute bronchitis
Reactive airway disease can occur as a result of acute bronchitis
Hemoptysis
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Conclution
Acute bronchitis is one of the top 10 conditions for which patients seek medical care.
Physicians show considerable variability in describing the signs and symptoms necessary
to its diagnosis. Because acute bronchitis most often has a viral cause,
symptomatic treatment with protussives, antitussives, or bronchodilators is appropriate.
However, studies indicate that many physicians treat bronchitis with antibiotics. These drugs
have generally been shown to be ineffective in patients with uncomplicated acute bronchitis.
Furthermore, antibiotics often have detrimental side effects, and their overuse
contributes to the increasing problem of antibiotic resistance. Patient satisfaction with the
treatment of acute bronchitis is related to the quality of the physician-patient interaction
rather than to prescription of an antibiotic. (Am Fam Physician 2002;65:2039-44, 2046.
Copyright 2002 American Academy of Family Physicians.)
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REFERENSI
1. Glick, Greenberg. Burkets Oral Medicine Diagnosis anmd Treatment. Tenth Edition.
Bc Decker Inc. Spain : 2006
2. Macnee W. Chronic Bronchitis And Emphysema. Antony S, Douglas S, Leitch A G.
Crofton And Douglass Respiratory Disease. Fifth Edition. Volume I. 2000. Page :
616
3.
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