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Acute bronchitis in adults

Thomas M File, Jr, MD
Section Editors
Daniel J Sexton, MD
Mark D Aronson, MD
Deputy Editor
Sheila Bond, MD


Acute bronchitis is one of the most common conditions encountered in clinical practice. It is a self-limited inflammation of the bronchi due to upper airway infection. Patients with acute bronchitis present with a cough lasting more than five days (typically one to three weeks), which may be associated with sputum production. Acute bronchitis should be distinguished from chronic bronchitis, a condition in patients with chronic obstructive pulmonary disease distinguished by a cough for at least three months in each of two successive years. (See "Chronic obstructive pulmonary disease: Definition, clinical manifestations, diagnosis, and staging", section on 'Definitions'.)

This respiratory condition is generally caused by a virus. However, reports indicate that more than 60 to 90 percent of patients with acute bronchitis who seek care are given antibiotics [1-4]. Additionally, 75 percent of all antibiotic prescriptions are written for upper respiratory infections [5].

Acute bronchitis caused by microbial infection will be reviewed here. Exacerbations of chronic bronchitis and treatment of viral upper respiratory infections are discussed separately. (See "Management of infection in exacerbations of chronic obstructive pulmonary disease" and "The common cold in adults: Treatment and prevention".)


The usual causes of acute bronchitis are viral infections of the upper airways including influenza A and B, parainfluenza, coronavirus (types 1-3), rhinovirus, respiratory syncytial virus, and human metapneumovirus [6]. Several case series examined the etiology of acute bronchitis in patients without underlying lung disease [7,8]. An etiologic agent was established in a minority of cases (29 percent of 42 episodes in one study [8], 16 percent of 113 patients in another [9]); viruses were the most common agents identified in both studies.

Although it has been suggested that the bacterial pathogens that cause pneumonia (eg, Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Moraxella catarrhalis, or even gram-negative bacilli) can also cause acute bronchitis, there is no convincing evidence to support the concept of "acute bacterial bronchitis" caused by these pathogens in adults. An exception is in patients with airway violations such as tracheostomy or endotracheal intubation, or those with exacerbations of chronic bronchitis. (See "Management of infection in exacerbations of chronic obstructive pulmonary disease".)


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Literature review current through: Mar 2017. | This topic last updated: Mar 25, 2016.
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