The majority of patients with have a normal chest examination, however, some patients may present with:
- Low-grade fever
- acute bronchitis is typically a clinical diagnosis
- however, if CRP testing is available this may be used to guide whether antibiotic therapy is indicated
- History: Sputum, wheeze, breathlessness may be absent in acute bronchitis whereas at least one tends to be present in pneumonia.
- Examination: No other focal chest signs (dullness to percussion, crepitations, bronchial breathing) in acute bronchitis other than wheeze. Moreover, systemic features (malaise, myalgia, and fever) may be absent in acute bronchitis, whereas they tend to be present in pneumonia.
- good fluid intake
- consider antibiotic therapy if patients:
- are systemically very unwell
- have pre-existing co-morbidities
- have a CRP of 20-100mg/L (offer delayed prescription) or a CRP >100mg/L (offer antibiotics immediately)
- NICE Clinical Knowledge Summaries/BNF currently recommend doxycycline first-line
- doxycycline cannot be used in children or pregnant women
- alternatives include amoxicillin