Acute bronchitisLast updated: January 20, 2021
Viral (> 90% of cases)
The etiology of acute bronchitis is viral in > 90% of cases!
Acute bronchitis is a clinical diagnosis based on typical clinical features and auscultation findings
- Diagnostic studies are usually only required to: 
- Rule out alternative diagnoses: e.g., CBC, CXR, nasopharyngeal swab
- Evaluate for complications (e.g., pneumonia, AECOPD) in patients with:
- Atypical clinical findings
Increased risk of bacterial infection: e.g., smokers, patients > 75 years old, patients with lung disease
Routine laboratory and imaging studies 
Further diagnostic testing 
Consider targeted testing for alternate diagnoses or complications in patients with the following:
In otherwise healthy patients with typical clinical findings and normal vital signs, acute bronchitis does not require diagnostic testing. 
The differential diagnoses listed here are not exhaustive.
Acute bronchitis is generally self-limiting. Treatment is focused on the relief of symptoms. 
Recommend rest and adequate hydration.
- Advise patients to avoid lung irritants (e.g., smoke, incense). 
- Reevaluate if any of the following:
Symptomatic treatment 
Antibiotic treatment 
Treatment is focused on symptomatic management. Antibiotics, cough and cold medications, bronchodilators, and steroids have no proven efficacy in uncomplicated acute bronchitis.
- Generally self-limiting
- Groups at increased risk for complications: elderly, immunocompromised patients, patients with pre-existing lung conditions
Diagnosis and treatment of acute bronchitis.
Updated: December 1, 2010.
Accessed: March 15, 2017.
- Jazeela F. Bronchitis. In: Mosenifar M, Bronchitis. New York, NY: WebMD. http://emedicine.medscape.com/article/297108. Updated: February 9, 2017. Accessed: March 15, 2017.
- File TM. Acute Bronchitis in Adults. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/acute-bronchitis-in-adults.Last updated: March 25, 2016. Accessed: March 16, 2017.
Kinkade S, Long NA. Acute Bronchitis.. Am Fam Physician. 2016; 94
Koehler U, Hildebrandt O, Fischer P, et al. Time course of nocturnal cough and wheezing in children with acute bronchitis monitored by lung sound analysis. Eur J Pediatr. 2019; 178
doi: 10.1007/s00431-019-03426-4 . | Open in Read by QxMD
Smith MP, Lown M, Singh S, et al. Acute Cough Due to Acute Bronchitis in Immunocompetent Adult Outpatients: CHEST Expert Panel Report.. Chest. 2020; 157
doi: 10.1016/j.chest.2020.01.044 . | Open in Read by QxMD
Harris AM, Hicks LA, Qaseem A. Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med. 2016; 164
doi: 10.7326/m15-1840 . | Open in Read by QxMD
Moore M, Stuart B, Little P, et al. Predictors of pneumonia in lower respiratory tract infections: 3C prospective cough complication cohort study.. Eur Respir J. 2017; 50
doi: 10.1183/13993003.00434-2017 . | Open in Read by QxMD
Kardos P, Lehrl S, Matthys H, Kamin W. The BSS - A Valid Clinical Instrument to Measure the Severity of Acute Bronchitis. J Lung Pulm Respir Res. 2014; 1
doi: 10.15406/jlprr.2014.01.00016 . | Open in Read by QxMD
Taussig LM, Landau LI. Pediatric Respiratory Medicine E-Book.
Elsevier Health Sciences
Shelledy DC, Peters JI. Respiratory Care: Patient Assessment and Care Plan Development.
Jones & Bartlett Publishers
Marini T, Hobbs SK, Chaturvedi A, Kaproth-Joslin K. Beyond bronchitis: a review of the congenital and acquired abnormalities of the bronchus. Insights Imaging. 2017; 8
doi: 10.1007/s13244-016-0537-y . | Open in Read by QxMD
Kline JM, Lewis WD, Smith EA, Tracy LR, Moerschel SK. Pertussis: a reemerging infection.. American family physician. 2013; 88
Zilong Zhang, Lixing Tan, Anke Huss, Cui Guo, Jeffrey R. Brook, Lap‐ah Tse, Xiang Q. Lao. Household incense burning and children's respiratory health: A cohort study in Hong Kong. Pediatr Pulmonol. 2019; 54
doi: 10.1002/ppul.24251 . | Open in Read by QxMD
Chest Cold (Acute Bronchitis).
Updated: August 30, 2019.
Accessed: December 23, 2020.
Llor C, Moragas A, Bayona C, et al. Efficacy of anti-inflammatory or antibiotic treatment in patients with non-complicated acute bronchitis and discoloured sputum: randomised placebo controlled trial.. BMJ. 2013; 347
doi: 10.1136/bmj.f5762 . | Open in Read by QxMD
Smith SM, Schroeder K, Fahey T. Over-the-counter (OTC) medications for acute cough in children and adults in community settings.. Cochrane Database Syst Rev. 2014
doi: 10.1002/14651858.CD001831.pub5 . | Open in Read by QxMD
Becker LA, Hom J, Villasis-Keever M, van der Wouden JC. Beta2-agonists for acute cough or a clinical diagnosis of acute bronchitis.. Cochrane Database Syst Rev. 2015
doi: 10.1002/14651858.CD001726.pub5 . | Open in Read by QxMD
Herold G. Internal Medicine.
Agabegi SS, Agabegi ED. Step-Up To Medicine.
Wolters Kluwer Health
Cohen HA, Rozen J, Kristal H, et al. Effect of honey on nocturnal cough and sleep quality: a double-blind, randomized, placebo-controlled study.. Pediatrics. 2012; 130
doi: 10.1542/peds.2011-3075 . | Open in Read by QxMD
Paul IM, Beiler J, McMonagle A, Shaffer ML, Duda L, Berlin CM Jr. Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents.. Arch Pediatr Adolesc Med. 2007; 161
doi: 10.1001/archpedi.161.12.1140 . | Open in Read by QxMD
Oduwole O, Udoh EE, Oyo-Ita A, Meremikwu MM. Honey for acute cough in children. Cochrane Database Syst Rev. 2018
doi: 10.1002/14651858.cd007094.pub5 . | Open in Read by QxMD