CHRONIC BRONCHITIS
This is chronic inflammation of the bronchial mucosa due to irritants
such as tobacco smoke. There is progressive worsening with age and
eventually resulting in chronic respiratory failure. It is part of the syndrome
of chronic obstructive pulmonary disease (COPD). It is aggravated by
recurrent viral and bacterial infections.
CAUSES
· Cigarette smoking
· Industrial dust
· Chemical irritants
SYMPTOMS
· Cough with production of clear sputum
· Fever and production of thick offensive sputum purulent and copious
during secondary bacterial infection
· Shortness of breath, with or without wheeze
SIGNS
Absence of signs does not exclude the disease
· Wheeze or rhonchi
· Reduced Peak Expiratory Flow Rate (PEFR) which does not increase with
treatment
INVESTIGATIONS
· FBC
· Spirometry
· Chest X-ray
· Sputum culture
TREATMENT
Treatment objectives
· To minimise or stop cough
· To reduce quantity of sputum produced
· To prevent or minimise wheeze and shortness of breath
Non-pharmacological treatment
· Smoking cessation, if patient is a smoker
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DISORDERS OF THE RESPIRATORY SYSTEM
Pharmacological treatment
(Evidence rating: C)
· Mucolytic syrup containing acetyl cysteine:
10 ml 8 hourly - if thick viscid sputum
· Salbutamol, Inhaled, (via aerosol)
100 microgram (2 puffs) 12 hourly and as needed
Or
Ipratropium bromide, Inhaled,
20 microgram (2 puffs) 12 hourly and as needed
Antibiotics for secondary infection
· Amoxicillin (Amoxycillin), oral,
Adults
500 mg 8 hourly for 7 days
Or
Erythromycin, oral,
Adults
500 mg 6 hourly for 7 days
Or
Azithromycin, oral,
Adults
500 mg daily for 3 days
REFER
Refer all complicated cases for specialist care.
