Acute Bronchitis

Question 1

What is the most common cause of acute bronchitis?

Answer 1

Viral infections are the leading cause of acute bronchitis.

Question 2

When are episodes of acute bronchitis most likely to occur?

Answer 2

Around 80% of episodes occur in autumn or winter.

Question 3

What are the typical presenting symptoms of acute bronchitis?

Answer 3

Acute onset of cough (may be productive),
sore throat,
rhinorrhoea,
wheeze.

Question 4

How can acute bronchitis be differentiated from pneumonia based on history?

Answer 4

In acute bronchitis, sputum, wheeze, and breathlessness may be absent, unlike in pneumonia where at least one is typically present.

Question 5

What are the focal chest signs of acute bronchitis on examination?

Answer 5

Acute bronchitis typically has no focal chest signs other than wheeze.

Question 6

What role does CRP testing play in the management of acute bronchitis?

Answer 6

CRP testing can guide antibiotic therapy:

CRP 20-100 mg/L: Consider delayed prescription

CRP >100 mg/L: Offer antibiotics immediately

Question 7

What is the first-line antibiotic recommended for acute bronchitis according to NICE/BNF?

Answer 7

Doxycycline is recommended first-line, except in children or pregnant women.

Question 8

What are alternative antibiotics to doxycycline for treating acute bronchitis?

Answer 8

Alternatives include amoxicillin, especially in children and pregnant women.