page 1: ACUTE BRONCHITIS OVERVIEW (introduction, pathophysiology, symptoms)
page 2: Use different current scholarly research/guidelines (WITHIN 5 YEARS) to discuss use of antibiotic treatment on acute bronchitis
Acute Bronchitis
Student Name
University
Course
Professor Name
Date
Acute Bronchitis
Acute bronchitis refers to the inflammation of the lower airways and the trachea. The annual incidence is estimated to be approximately 5 percent of the general population with most cases occurring during the flu season. The causal agent is mainly viral and the most common viruses include influenza A and B, enterovirus, rhinovirus, respiratory syncytial virus, and coronavirus. Viruses represent approximately 90 percent of the cases while bacterial agents represent ten percent of the cases. Examples of bacterial agents include Bordetella pertussis, Chlamydophila pneumonia, and Mycoplasma pneumonia (Nowicki & Murray, 2020). The purpose of this paper is to discuss the pathophysiology, symptoms, and antibiotic treatment of acute bronchitis.
Pathophysiology
The pathophysiology of acute bronchitis begins with triggers such as viral infections, pollutants, and allergens which lead to inflammation of the bronchi. When the bronchial walls are inflamed, the result is mucosal thickening, basement membrane denudation, and desquamation of the epithelial-cell. Upper respiratory infections lead to bronchitis when they progress to the lower respiratory tract (Smith et al., 2020).
Symptoms
Patients suffering from acute bronchitis present with symptoms such as malaise, productive cough, wheezing, and difficulty breathing. The cough is usually the main complaint with yellowish or clear sputum although in some cases, it may be purulent. Patients may experience persistent cough lasting for twenty days or more although the average duration is 18 days. The cough is usually bothersome and difficult to resolve. Low-grade fevers are also common symptoms while high grade fevers are unusual and require more diagnostic tests. Other symptoms may include headache, sore throat, chills, back and muscle pain, and watery eyes. Physical exams such as lung auscultation may be used to detect wheezing. Symptoms such as tachycardia reflect viral illness (Smith et al., 2020).
Use of antibiotic treatment on acute bronchitis
The use of antibiotics is a controversial area among healthcare professionals. Research evidence illustrates that antibiotics do not result in changes in the course and progression of acute bronchitis. Antibiotic treatment is not recommended for uncomplicated cases of acute bronchitis regardless of the cough duration. However, antibiotics are prescribed as the main line of treatment for approximately 80 percent of patients implying that they are overused. Antibiotics may improve patient outcomes for bacterial infections but not for viral cases (Medical Associates, 2020). Among pediatric patients, antibiotics are also overused since it is difficult to detect whether the infection is bacterial or viral. However, antibacterial therapy can be justified among pediatric patients who need mechanical ventilation and intubation for respiratory failure. Inappropriate use of antibiotics may lead to drug resistance and may result in adverse effects such as vomiting, nausea, and allergic reactions (Grigoryan et al., 2017).
There are situations where antibiotic treatment may be used. In case healthcare professionals suspect pertussis, the recommendation is to initiate macrolide antibiotics to minimize the risk of transmission. However, it is important to note that antibiotics do not minimize symptom duration although in some cases, they may reduce the risk of developing pneumonia (Zhang & Liu, 2020). Serological markers can be used to guide the use of antibiotics due to clinical uncertainty. The procalcitonin levels can be used to guide treatment decisions to reduce antibiotic use especially among patients whose clinical outcomes are not affected by these medications. Assessing the patients’ C-reactive protein levels may also help to distinguish cases of inappropriate antibiotic prescriptions without affecting the outcomes of the patient (Medical Associates, 2020).
References
Grigoryan, L., Zoorob, R., Shah, J., Wang, H., Arya, M., & Trautner, B. (2017). Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults. Antibiotics, 6(4), 22. https://doi.org/10.3390/antibiotics6040022
Medical Associates. (2020). Clinical Practice Guideline for Treatment of Acute Bronchitis. https://www.mahealthcare.com/pdf/practice_guidelines/Treatment_of_Acute_Bronchitis.pdf.
Nowicki, J., & Murray, M. (2020). Bronchitis and Pneumonia. Textbook of Natural Medicine, 1196-1201. https://doi.org/10.1016/b978-0-323-43044-9.00155-2
Smith, M., Lown, M., Singh, S., Ireland, B., Hill, A., & Linder, J. et al. (2020). Acute Cough Due to Acute Bronchitis in Immunocompetent Adult Outpatients. Chest, 157(5), 1256-1265. https://doi.org/10.1016/j.chest.2020.01.044
Zhang, F., & Liu, J. (2020). Quality assessment of clinical practice guidelines of Chinese and western medicine for acute bronchitis. European Journal of Integrative Medicine, 34, 101045. https://doi.org/10.1016/j.eujim.2019.101045