ACUTE BRONCHITIS
This refers to an acute infection of the bronchial mucosa. It is often
found in association with upper respiratory tract infection. Most of the cases
are viral and do not require antibiotics for treatment.
Antibiotics should however be prescribed if the patient is very ill or
breathless or has an underlying illness like malnutrition, measles, rickets,
anaemia, diabetes mellitus, chronic bronchitis, HIV/AIDS.
CAUSES
· Bacteria e.g. Streptococci, Staph. aureus, H. influenza
· Viruses e.g. Influenza virus
SYMPTOMS
· Initial dry cough, later productive
· Anterior chest pain aggravated by coughing
· Low grade fever
SIGNS
· Fever
· Rhinorrhoea
· Crepitations and rhonchi
INVESTIGATIONS
· FBC
· Sputum culture
TREATMENT
Treatment objectives
· To relieve symptoms
· To treat suspected bacterial infection
Non-pharmacological treatment
· Bed rest
· Keep well hydrated
· Give humidified air if possible
Pharmacological treatment
(Evidence rating: C)
· Paracetamol, oral,
Adults
500 mg-1g 6-8 hourly
135
DISORDERS OF THE RESPIRATORY SYSTEM
Children
6-12 years; 250-500 mg 6-8 hourly
1-5 years; 120-250 mg 6-8 hourly
3 months-1 year; 60-120 mg 6-8 hourly
Plus
· Amoxicillin (Amoxycillin), oral,
Adults
500 mg 8 hourly for 7 days
Children
6-12 years; 250 mg 8 hourly for 7 days
1-5 years; 125 mg 8 hourly for 7 days
<1 year; 62.5 mg 8 hourly for 7 days
Or
Co-amoxiclav, oral,
Adults
One 500/125 tablet 12 hourly
Children
> 12 years; One 500/125 tablet 12 hourly for 7 days
6-12 years; 5 ml of 400/57 suspension 12 hourly for
7 days
1-6years; 2.5ml of 400/57 suspension 12 hourly for
7 days
1month-1 year; 0.25ml/kg body weight of 125/31
suspension 8 hourly for 7 days
< 1 month; 0.25ml/kg body weight of 125/31
suspension 8 hourly for 7 days
Note
Double the dose of the above antibiotic in severe infections
For individuals allergic to penicillin:
· Erythromycin, oral,
Adults
250-500 mg 6 hourly 7 days
Children
8-18 years; 250-500 mg 6 hourly 7 days
2-8 years; 250 mg 6 hourly 7 days
6 months-2 years; 125 mg 6 hourly 7 days
Or
Azithromycin, oral,
Adults
500 mg once daily for 3 days
Children
10 mg/kg once daily for 3 days
