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Bronchitis vs URI: Understanding Upper Respiratory Infections and Acute Bronchitis

by alexxlab

What are the key differences between bronchitis and upper respiratory infections. How do symptoms, causes, and treatments compare for these common respiratory conditions. What preventive measures can reduce the risk of developing bronchitis or URI.

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The Prevalence and Impact of Upper Respiratory Infections

Upper respiratory infections (URIs) are among the most common illnesses affecting people worldwide. These infections, which primarily involve the nose, throat, and airways, can be caused by various viruses and occasionally bacteria. Understanding their prevalence and impact is crucial for both healthcare providers and the general public.

How common are URIs? Studies have shown that adults typically experience 2-4 colds per year, while children may have 6-8 episodes annually. The economic burden of non-influenza-related viral respiratory tract infections in the United States is estimated to be billions of dollars annually, considering both direct medical costs and lost productivity.

Key Facts About URI Prevalence:

  • URIs account for millions of doctor visits each year
  • They are a leading cause of work and school absenteeism
  • The common cold, a type of URI, affects people of all ages and demographics

Is there a seasonal pattern to URIs? While these infections can occur year-round, they tend to peak during fall and winter months in temperate climates. This seasonality is attributed to factors such as increased indoor crowding, changes in humidity, and variations in immune system function.

Etiology of Upper Respiratory Infections: Viral vs. Bacterial Causes

Understanding the causes of URIs is essential for proper diagnosis and treatment. The vast majority of these infections are viral in origin, with rhinoviruses being the most common culprits.

Common Viral Causes of URIs:

  1. Rhinoviruses
  2. Coronaviruses
  3. Adenoviruses
  4. Parainfluenza viruses
  5. Respiratory syncytial virus (RSV)

What percentage of URIs are caused by viruses? Studies indicate that viruses are responsible for about 90-95% of URIs. Bacterial infections, while less common, can also cause upper respiratory symptoms, particularly in cases of sinusitis or strep throat.

How do viral URIs differ from bacterial infections? Viral infections typically have a gradual onset, last 7-10 days, and are self-limiting. Bacterial infections often have a more sudden onset, may cause more severe symptoms, and are more likely to respond to antibiotic treatment.

Symptoms and Diagnosis of Upper Respiratory Infections

Recognizing the symptoms of URIs is crucial for proper self-care and knowing when to seek medical attention. While symptoms can vary depending on the specific pathogen and individual factors, there are common manifestations shared by most URIs.

Typical Symptoms of URIs:

  • Nasal congestion and discharge
  • Sore throat
  • Cough
  • Mild fever
  • Fatigue
  • Headache

How are URIs diagnosed? Diagnosis is typically based on clinical presentation and physical examination. Laboratory tests are rarely necessary for uncomplicated cases. However, in certain situations, such as prolonged or severe symptoms, additional testing may be warranted to rule out other conditions or identify specific pathogens.

Can URIs be distinguished from other respiratory conditions? While URIs share symptoms with other respiratory illnesses, certain characteristics can help differentiate them. For example, URIs generally do not cause shortness of breath or chest pain, which are more common in lower respiratory tract infections like pneumonia.

Treatment Approaches for Upper Respiratory Infections

The management of URIs primarily focuses on symptom relief, as most cases are self-limiting and resolve without specific antiviral or antibiotic therapy. However, understanding appropriate treatment strategies is essential for patient comfort and preventing complications.

Common Treatment Approaches for URIs:

  1. Rest and hydration
  2. Over-the-counter pain relievers and fever reducers
  3. Decongestants and antihistamines
  4. Nasal saline irrigation
  5. Humidification

Are antibiotics effective for treating URIs? Antibiotics are generally not recommended for uncomplicated URIs, as they are ineffective against viral infections and can contribute to antibiotic resistance. However, they may be prescribed in cases of suspected bacterial complications or in high-risk patients.

What about antiviral medications? While some antiviral drugs exist for specific respiratory viruses (e.g., oseltamivir for influenza), there are no widely effective antiviral treatments for the common cold or most other URIs. Research into potential antiviral therapies is ongoing.

Understanding Acute Bronchitis: Causes and Characteristics

Acute bronchitis is an inflammation of the bronchial tubes, often developing as a complication of an upper respiratory infection. While it shares some similarities with URIs, acute bronchitis has distinct characteristics that set it apart.

Key Features of Acute Bronchitis:

  • Persistent cough lasting 1-3 weeks
  • Production of mucus (clear, white, yellow, or green)
  • Chest discomfort or soreness
  • Mild fever and chills
  • Fatigue and body aches

What causes acute bronchitis? Like URIs, acute bronchitis is most commonly caused by viruses. However, bacterial infections, irritants (such as tobacco smoke or air pollution), and allergens can also trigger bronchial inflammation.

How does acute bronchitis differ from chronic bronchitis? Acute bronchitis is a temporary condition that typically resolves within a few weeks. Chronic bronchitis, on the other hand, is a long-term condition characterized by persistent inflammation and mucus production, often associated with smoking or other long-term irritant exposure.

Diagnosing and Treating Acute Bronchitis

Proper diagnosis and management of acute bronchitis are crucial for patient comfort and preventing unnecessary antibiotic use. Healthcare providers must differentiate acute bronchitis from other respiratory conditions to determine the most appropriate treatment approach.

Diagnostic Approaches for Acute Bronchitis:

  1. Clinical evaluation and patient history
  2. Physical examination, including lung auscultation
  3. Chest X-ray (in some cases to rule out pneumonia)
  4. Sputum culture (if bacterial infection is suspected)

How is acute bronchitis typically treated? Treatment for acute bronchitis is primarily supportive, focusing on symptom relief. This may include:

  • Rest and increased fluid intake
  • Over-the-counter cough suppressants or expectorants
  • Bronchodilators (for wheezing)
  • Pain relievers for fever and discomfort

Are antibiotics necessary for acute bronchitis? In most cases, antibiotics are not recommended for acute bronchitis, as the condition is typically viral. However, antibiotics may be prescribed if there is strong suspicion of a bacterial infection or in patients with underlying lung disease.

Preventing Upper Respiratory Infections and Acute Bronchitis

Prevention plays a crucial role in reducing the incidence of URIs and acute bronchitis. While it’s not always possible to avoid these infections entirely, certain measures can significantly lower the risk of contracting or spreading respiratory pathogens.

Effective Prevention Strategies:

  • Frequent hand washing with soap and water
  • Using alcohol-based hand sanitizers when soap is unavailable
  • Avoiding close contact with infected individuals
  • Practicing good respiratory hygiene (covering mouth and nose when coughing or sneezing)
  • Maintaining a healthy lifestyle (balanced diet, regular exercise, adequate sleep)
  • Avoiding tobacco smoke and other airborne irritants

Do vaccines help prevent URIs and acute bronchitis? While there is no vaccine for the common cold or most causes of acute bronchitis, certain vaccinations can help prevent specific respiratory infections. These include:

  1. Annual influenza vaccine
  2. Pneumococcal vaccine (for high-risk individuals)
  3. COVID-19 vaccine

Can dietary supplements or herbal remedies prevent URIs? Some studies suggest that certain supplements, such as vitamin C, zinc, and echinacea, may have a modest effect in reducing the duration or severity of URIs. However, evidence is mixed, and these should not be relied upon as the primary prevention strategy.

Complications and When to Seek Medical Attention

While most URIs and cases of acute bronchitis resolve without serious complications, it’s important to recognize signs that may indicate a more severe condition or the need for medical intervention.

Potential Complications of URIs and Acute Bronchitis:

  • Sinusitis
  • Otitis media (ear infection)
  • Pneumonia
  • Exacerbation of underlying respiratory conditions (e.g., asthma, COPD)

When should you seek medical attention for a URI or acute bronchitis? It’s advisable to consult a healthcare provider if you experience:

  1. Symptoms persisting beyond 10-14 days
  2. High fever (above 101°F or 38.3°C) or fever lasting more than 3 days
  3. Severe shortness of breath or chest pain
  4. Coughing up blood
  5. Signs of dehydration
  6. Worsening symptoms after initial improvement

Are certain populations at higher risk for complications? Yes, individuals with weakened immune systems, chronic medical conditions, young children, and older adults may be more susceptible to complications from URIs and acute bronchitis. These groups should be monitored more closely and may benefit from earlier medical evaluation.

The Role of Antibiotic Stewardship in Managing Respiratory Infections

Antibiotic stewardship is a critical aspect of managing URIs and acute bronchitis. The overuse and misuse of antibiotics have contributed to the growing problem of antibiotic resistance, making it essential for healthcare providers and patients to understand when antibiotics are truly necessary.

Key Principles of Antibiotic Stewardship:

  • Prescribing antibiotics only when clinically indicated
  • Choosing the appropriate antibiotic for the suspected pathogen
  • Using the correct dosage and duration of treatment
  • Educating patients about proper antibiotic use
  • Monitoring and reporting antibiotic resistance patterns

How has antibiotic prescribing for URIs changed over time? Studies have shown a decline in antibiotic prescriptions for URIs in recent years, reflecting increased awareness of antibiotic resistance and improved adherence to clinical guidelines. However, inappropriate antibiotic use remains a concern in many healthcare settings.

What strategies can healthcare providers use to reduce unnecessary antibiotic prescriptions? Effective approaches include:

  1. Implementing delayed prescribing strategies
  2. Using point-of-care testing to distinguish viral from bacterial infections
  3. Providing patient education about the natural course of viral infections
  4. Offering symptomatic relief and follow-up instructions

By adhering to antibiotic stewardship principles, healthcare providers can help preserve the effectiveness of these important medications while still providing appropriate care for patients with respiratory infections.

Upper Respiratory Infections and Acute Bronchitis

1. Gwaltney JM, Jr, Hendley JO, Simon G, et al. Rhinovirus infections in an industrial population. II. Characteristics of illness and antibody response. JAMA. 1967;202:494. doi: 10.1001/jama.202.6.494. [PubMed] [CrossRef] [Google Scholar]

2. Gohd RS. The common cold. N Engl J Med. 1954;250:687–691. doi: 10.1056/NEJM195404222501606. [PubMed] [CrossRef] [Google Scholar]

3. Schappert SM. National Ambulatory Medical Care Survey: 1991 Summary. Vital Health Stat 13(116) Hyattsville, MD: National Center for Health Statistics; 1994. [PubMed] [Google Scholar]

4. Hing E, Cherry DK, Woodwell DA. National Ambulatory Medical Care Survey: 2003 Summary. Advance Data from Vital and Health Statistics, no. 365. Hyattsville, MD: National Center for Health Statistics; 2005. [Google Scholar]

5. Croughan-Minihane MS, Petitti DB, Rodnick JE, Eliaser G. Clinical trial examining effectiveness of three cough syrups. J Am Board Fam Pract. 1993;6:109–115. [PubMed] [Google Scholar]

6. Sperber SJ, Levine PA, Sorrentino JV, Riker DK, et al. Ineffectiveness of recombinant interferon-beta serine nasal drops for prophylaxis of natural colds. J Infect Dis. 1989;160:700–705. doi: 10.1093/infdis/160.4.700. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

7. Cherry DK, Woodwell DA, Rechtsteiner EA. National Ambulatory Medical Care Survey: 2005 Summary. Advance Data from Vital and Health Statistics, no. 387. Hyattsville, MD: National Center for Health Statistics; 2007. [PubMed] [Google Scholar]

8. Carroll K, Reimer L. Microbiology and laboratory diagnosis of upper respiratory tract infections. Clin Infect Dis. 1996;23:442–448. doi: 10.1093/clinids/23.3.442. [PubMed] [CrossRef] [Google Scholar]

9. Fendrick AM, Monto AS, Nightengale B, Sarnes M. The economic burden of non-influenza-related viral respiratory tract infection in the United States. Arch Intern Med. 2003;163:487–494. doi: 10.1001/archinte. 163.4.487. [PubMed] [CrossRef] [Google Scholar]

10. Committee on Infectious Diseases . Report of the Committee of Infectious Diseases. 23. Elk Grove, IL: American Academy of Pediatrics; 1994. [Google Scholar]

11. Centers for Disease Control and Prevention General recommendations on immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR. 1994;43:1–38. [PubMed] [Google Scholar]

12. Holt E, Guyer B, Hughart N, et al. The contribution of missed opportunities to childhood underimmunization in Baltimore. Pediatrics. 1996;97:474–480. [PubMed] [Google Scholar]

13. Sattar SA, Jacobsen H, Springthorpe VS, et al. Chemical disinfection to interrupt transfer of rhinovirus type 14 from environmental surfaces to hands. Appl Environ Microbiol. 1993;59:1579–1585. [PMC free article] [PubMed] [Google Scholar]

14. Ansari SA, Springthorpe VS, Sattar SA, et al. Potential role of hands in the spread of respiratory viral infections: Studies with human parainfluenza virus 3 and rhinovirus 14. J Clin Microbiol. 1991;29:2115–2119. [PMC free article] [PubMed] [Google Scholar]

15. Warshauer DM, Dick EC, Mandel AD, et al. Rhinovirus infections in an isolated antarctic station. Transmission of the viruses and susceptibility of the population. Am J Epidemiol. 1989;129:319–340. [PubMed] [Google Scholar]

16. Jackson GG, Muldoon RL. Viruses causing common respiratory infections in man. J Infect Dis. 1973;127:328–355. doi: 10.1093/infdis/127.3.328. [PubMed] [CrossRef] [Google Scholar]

17. Makela MJ, Puhakka T, Ruuskanen O, et al. Viruses and bacteria in the etiology of the common cold. J Clin Microbiol. 1998;36:539–542. [PMC free article] [PubMed] [Google Scholar]

18. Mainous AGIII, Hueston WJ, Clark JR. Antibiotics and upper respiratory infection: Do some folks think there is a cure for the common cold? J Fam Pract. 1996;42:357–361. [PubMed] [Google Scholar]

19. Gonzales R, Steiner JF, Sande MA. Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians. JAMA. 1997;278:901–904. doi: 10.1001/jama.278.11.901. [PubMed] [CrossRef] [Google Scholar]

20. Vanderweil SG, Pelletier AJ, Hamedani AG, et al. Declining antibiotic prescriptions for upper respiratory infections, 1993–2004. Acad Emerg Med. 2007;14:366–369. [PubMed] [Google Scholar]

21. Hardy LM, Traisman HS. Antibiotics and chemotherapeutic agents in the treatment of uncomplicated respiratory infections in children. J Pediatr. 1956;48:146–156. doi: 10.1016/S0022-3476(56)80160-1. [PubMed] [CrossRef] [Google Scholar]

22. Lexomboon U, Duangmani C, Kusalasai V, et al. Evaluation of orally administered antibiotics for treatment of upper respiratory infections in Thai children. J Pediatr. 1971;78:772–778. doi: 10.1016/S0022-3476(71)80347-5. [PubMed] [CrossRef] [Google Scholar]

23. Taylor B, Abbott GD, Kerr MM, et al. Amoxycillin and co-trimoxazole in presumed viral respiratory infections of childhood: Placebo-controlled trial. Br Med J. 1977;2:552–554. doi: 10.1136/bmj. 2.6086.552. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

24. Stott NC, West RR. Randomised controlled trial of antibiotics in patients with cough and purulent sputum. Br Med J. 1976;2:556–559. doi: 10.1136/bmj.2.6035.556. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

25. Kaiser L, Lew D, Hirschel B, et al. Effects of antibiotic treatment in the subset of common-cold patients who have bacteria in nasopharyngeal secretions. Lancet. 1996;347:1507–1510. doi: 10.1016/S0140-6736(96)90670-4. [PubMed] [CrossRef] [Google Scholar]

26. Douglas RM, Hemila H, Chalrker E et al. (2007). Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev (3):CD000980 [PubMed]

27. Arroll B. Non-antibiotic treatments for upper-respiratory tract infections (common cold) Respir Med. 2005;99:1477–1484. doi: 10.1016/j.rmed.2005.09.039. [PubMed] [CrossRef] [Google Scholar]

28. Gwaltney JM, Jr, Park J, Paul RA, et al. Randomized controlled tiral of clemastine fumarate for treatment of experimental rhinovirus colds. Clin Infect Dis. 1996;22:656–662. doi: 10.1093/clinids/22.4.656. [PubMed] [CrossRef] [Google Scholar]

29. Holleman DR, Jr, Williams JW, Jr, Simel DL. Usual care and outcomes in patients with sinus complaints and normal results of sinus roentgenography. Arch Fam Med. 1995;4:246–251. doi: 10.1001/archfami.4.3.246. [PubMed] [CrossRef] [Google Scholar]

30. Manning SC, Biavati MJ, Phillips DL. Correlation of clinical sinusitis signs and symptoms to imaging findings in pediatric patients. Int J Pediatr Otorhinolaryngol. 1996;37:65–74. doi: 10.1016/0165-5876(96)01381-X. [PubMed] [CrossRef] [Google Scholar]

31. Lindbaek M, Hjortdahl P, Johnsen ULH. Use of symptoms, signs and blood tests to diagnose acute sinus infections in primary care: Comparison with computed tomography. Fam Med. 1996;28:183–186. [PubMed] [Google Scholar]

32. Williams JW, Jr, Simel DL. Does this patient have sinusitis? Diagnosing acute sinusitis by history and physical examination. JAMA. 1993;270:1242–1246. doi: 10.1001/jama.270.10.1242. [PubMed] [CrossRef] [Google Scholar]

33. Shapiro GG, Rahelefsky GS. Introduction and definition of sinusitis. J Allergy Clin Immunol. 1992;90:417–418. doi: 10.1016/0091-6749(92)90160-4. [PubMed] [CrossRef] [Google Scholar]

34. Aitkin M, Taylor JA. Prevalence of clinical sinusitis in young children followed up by primary care pediatricians. Arch Pediatr Adolesc Med. 1998;152:244–248. [PubMed] [Google Scholar]

35. Gordts F, Clement PA, Destryker A, et al. Prevalence of sinusitis signs on MRI in a non-ENT paediatric population. Rhinology. 1997;35:154–157. [PubMed] [Google Scholar]

36. Henriksson G, Westrin KM, Kumlien J, et al. A 13-year report on childhood sinusitis: Clinical presentations, predisposing factors and possible means of prevention. Rhinology. 1996;34:171–175. [PubMed] [Google Scholar]

37. Van Bucham FL, Knottnerus JA, Schrijnemaekers VJJ, et al. Primary-case-based randomised placebo-controlled trial of antibiotic treatment in acute maxillary sinusitis. Lancet. 1997;349:683–687. doi: 10.1016/S0140-6736(96)07585-X. [PubMed] [CrossRef] [Google Scholar]

38. Lindbaek M, Hjortdahl P, Johnsen U. Randomised, double blind, placebo controlled trial of penicillin V and amoxycillin in treatment of acute sinus infection in adults. BMJ. 1996;313:325–329. [PMC free article] [PubMed] [Google Scholar]

39. Evans KL. Diagnosis and management of sinusitis. Lancet. 1994;309:1415–1422. [PMC free article] [PubMed] [Google Scholar]

40. Stalman W, van Essen GA, van der Graaf Y. The end of antibiotic treatment in adults with acute sinusitis-like complaints in general practice? A placebo-controlled double-blind randomized doxycycline trial. Br J Gen Pract. 1997;47:794–799. [PMC free article] [PubMed] [Google Scholar]

41. Williams JW, Jr, Holleman DR, Jr, Samsa GP, et al. Randomized controlled trial of 3 vs 10 days of trimethoprim/sulfamethoxazole for acute maxillary sinusitis. JAMA. 1995;273:1015–1021. doi: 10.1001/jama.273.13.1015. [PubMed] [CrossRef] [Google Scholar]

42. De Bock GH, Dekker FW, Stolt J, et al. Antimicrobial treatment in acute maxillary sinusitis: A meta-analysis. J Clin Epidemiol. 1997;50:881–890. doi: 10.1016/S0895-4356(97)00117-0. [PubMed] [CrossRef] [Google Scholar]

43. Froom J, Culpepper L, Grob P, Bartelds A, et al. Diagnosis and antibiotic treatment of acute otitis media: Report from International Primary Care Network. BMJ. 1990;300:528–586. doi: 10.1136/bmj.300.6724.582. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

44. American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media Diagnosis and management of acute otitis media. Pediatrics. 2004;113:1451–1465. doi: 10.1542/peds.113.5.1451. [PubMed] [CrossRef] [Google Scholar]

45. Plasschaert AI, Rovers MM, Schilder AG, et al. Trends in doctor consultations, antibiotic prescription and specialist referrals for otitis media in children: 1995–2003. Pediatrics. 2006;117:1879–1886. doi: 10.1542/peds.2005-2470. [PubMed] [CrossRef] [Google Scholar]

46. Sox CM, Finkelstein JA, Yin R, et al. Trends in otitis media treatment and relapse. Pediatrics. 2008;121:674–679. doi: 10.1542/peds.2007-1565. [PubMed] [CrossRef] [Google Scholar]

47. Fisher T, Singer AJ, Lee C, Thode HC., Jr National trends in emergency department antibiotic prescribing in children with acute otitis media, 1996–2005. Acad Emerg Med. 2007;14:1172–1175. [PubMed] [Google Scholar]

48. Bluestone CD. Otitis media in children: To treat or not to treat? N Engl J Med. 1982;306:1399–1404. doi: 10.1056/NEJM198206103062305. [PubMed] [CrossRef] [Google Scholar]

49. Spiro DM, Tay KY, Arnold DH, et al. Wait-and-see prescription for the treatment of acute otitis media: A randomized controlled trial. JAMA. 2006;206:1235–1241. doi: 10.1001/jama.296.10.1235. [PubMed] [CrossRef] [Google Scholar]

50. Vernacchio L, Vezina RM, Mitchell AA. Management of acute otitis media by primary care physicians: Trends since the release of the 2004 American Academy of Pediatrics/American Academy of Family Physicians clinical practice guidelines. Pediatrics. 2007;120:281–287. doi: 10.1542/peds.2006-3601. [PubMed] [CrossRef] [Google Scholar]

51. Kozyrskyi A, Hildes-Ripstein GE, Longstaffe SEA, et al. Treatment of acute otitis media with a shortened course of antibiotics. JAMA. 1998;279:1736–1742. doi: 10.1001/jama.279.21.1736. [PubMed] [CrossRef] [Google Scholar]

52. Green SM, Rothrock SG. Single-dose intramuscular ceftriaxone for acute otitis media in children. Pediatrics. 1993;91:23–30. [PubMed] [Google Scholar]

53. Chamberlain JM, Boenning DA, Waisman Y, et al. Single-dose ceftiraxone versus 10 days of cefaclor for otitis media. Clin Pediatr. 1994;33:642–646. doi: 10.1177/000992289403301101. [PubMed] [CrossRef] [Google Scholar]

54. Barnett ED, Teele DS, Klein JO, et al. Comparison of ceftriaxone and trimethoprim-sulfamethoxasole for acute otitis media. Pediatrics. 1997;99:23–28. doi: 10.1542/peds.99.1.23. [PubMed] [CrossRef] [Google Scholar]

55. Soley CA, Arguedas A. Single-dose azithromycin for the treatment of children with acute otitis media. Expert Rev Anti Infect Ther. 2005;3(5):707–717. doi: 10.1586/14787210.3.5.707. [PubMed] [CrossRef] [Google Scholar]

56. Kaplan B, Wandstrat TL, Cunningham JR. Overall cost in the treatment of otitis media. Pediatr Infect Dis J. 1997;16(2 suppl):S9–S11. [PubMed] [Google Scholar]

57. Hathaway TJ, Katz HP, Dershewitz RA, Marx TJ. Acute otitis media: Who needs post treatment follow-up? Pediatrics. 1994;94:143–147. [PubMed] [Google Scholar]

58. Puczynski MS, Stankiewicz JA, Cunningham DG, et al. Follow-up visit after acute otitis media. Br J Clin Pract. 1985;39(4):132–135. [PubMed] [Google Scholar]

59. Hueston WJ, Ornstein S, Jenkins RG, et al. Treatment of recurrent otitis media after a previous treatment failure: Which antibiotics work best? J Fam Pract. 1999;48:43–46. [PubMed] [Google Scholar]

60. Valkenburg HA, Havorkorn MJ, Goslings WRO, et al. Streptococcal pharynfitis in the general population. J Infect Dis. 1971;124:348–358. doi: 10.1093/infdis/124.4.348. [PubMed] [CrossRef] [Google Scholar]

61. Siegel AC, Johnson EE, Stollerman GH. Controlled studies of streptococcal pharyngitis in a pediatric population. N Engl J Med. 1961;565:559–571. doi: 10.1056/NEJM196109212651201. [CrossRef] [Google Scholar]

62. Richardson MA. Sore throat, tonsillitis, and adenoiditis. Otolaryngol Clin North Am. 1999;83:75–83. [PubMed] [Google Scholar]

63. Little P, Williamson I, Warner G, et al. Open randomised trial of prescribing strategies in managing sore throat. BMJ. 1997;314:722–727. [PMC free article] [PubMed] [Google Scholar]

64. Reed BD, Huck W, Lutz L, et al. Prevalence of chlamydia trachomatis and mycoplasma pneumonia in children with and without pharyngitis. J Fam Pract. 1987;26:387–392. [PubMed] [Google Scholar]

65. Kaplan EL, Top FH, Dudding BA, et al. Diagnosis of streptococcal pharyngitis: Differentiation of active infection from the carrier state in the symptomatic child. J Infect Dis. 1971;123:490–501. doi: 10.1093/infdis/123. 5.490. [PubMed] [CrossRef] [Google Scholar]

66. Randolph MF, Gerber MA, DeMeo KK, Wright L. Effect of antibiotic therapy on the clinical course of streptococcal pharyngitis. J Pediatr. 1985;106:870–875. doi: 10.1016/S0022-3476(85)80228-6. [PubMed] [CrossRef] [Google Scholar]

67. Petersen I, Johnson AM, Islam A, et al. Protective effect of antibiotics against serious complications of common respiratory tract infections: Retrospective cohort study with the UK General Practice Research Database. BMJ. 2007;335:982. doi: 10.1136/bmj.39345.405243.BE. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

68. Gerber MA, Baltimore RS, Eaton CB, Gewitz M, Rowley AH, Shulman ST, Taubert KA. Prevention of rheumatic fever and diagnosis and treatment of acute streptococcal pharyngitis. Circulation. 2009;119:1541–1551. doi: 10.1161/CIRCULATIONAHA.109.191959. [PubMed] [CrossRef] [Google Scholar]

69. Dagnelie CF, Bartelink ML, van der Graaf Y, et al. Towards a better diagnosis of throat infections (with group A beta-hemolytic stretococcus) in general practice. Br J Gen Pract. 1998;48:959–962. [PMC free article] [PubMed] [Google Scholar]

70. McIsaac WJ, White D, Tannenbaum D, Low DE. A clinical score to reduce unnecessary antibiotic use in patient with sore throat. CMAJ. 1998;158:75–83. [PMC free article] [PubMed] [Google Scholar]

71. Dobbs F. A scoring system for predicting group A streptococcal throat infection. Br J Gen Pract. 1996;46:461–464. [PMC free article] [PubMed] [Google Scholar]

72. Ebell MH, Smith MA, Barry HC, et al. The rational clinical examination. Does this patient have strep throat? JAMA. 2000;284:2912–2918. doi: 10.1001/jama.284.22.2912. [PubMed] [CrossRef] [Google Scholar]

73. Webb KH. Does culture confirmation of high-sensitivity rapid streptococcal tests make sense? A medical decision analysis. Pediatrics. 1998;101:E2. doi: 10.1542/peds.101.2.e2. [PubMed] [CrossRef] [Google Scholar]

74. Petersen K, Phillips RS, Soukup J, et al. The effect of erythromycin on resolution of symptoms among adults with pharyngitis not caused by group A streptococcus. J Gen Intern Med. 1997;12:95–101. doi: 10.1007/s11606-006-5003-y. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

75. Little P, Gould C, Williamson I, et al. Reattendance and cmplications in a randomised trial of prescribing strategies for sore throat: The medicalising effect of prescribing antibiotics. BMJ. 1997;315:350–352. [PMC free article] [PubMed] [Google Scholar]

76. Dippel DWJ, Touw-Otten F, Habema JDF. Management of children with acute pharyngitis: A decision analysis. J Fam Pract. 1992;34:149–159. [PubMed] [Google Scholar]

77. Feder HM, Gerber MA, Randolph MF, et al. Once daily therapy for streptococcal pharyngitis with amoxicillin. Pediatrics. 1999;103:47–51. doi: 10.1542/peds.103.1.47. [PubMed] [CrossRef] [Google Scholar]

78. Gopicharnd I, Williams GD, Medendorp SV, et al. Randomized, single-blinded comparative study of the efficacy of amoxicillin (40 mg/kg/day) versus standard-dose penicillin V in the treatment of group A streptococcal pharyngitis in children. Clin Pediatr. 1998;37:341–346. doi: 10.1177/000992289803700602. [PubMed] [CrossRef] [Google Scholar]

79. Kearsley NL, Campbell A, Sanderson AA, Weir RD, et al. Comparison of clarithromycin suspension and amoxycillin syrup for the treatment of children with pharyngitis and/or tonsillitis. Br J Clin Pract. 1997;51:133–137. [PubMed] [Google Scholar]

80. O’Doherty B. Azithromycin versus penicillin V in the treatment of paediatric patients with acute streptococcal pharyngitis/tonsillitis. Paediatric Azithromycin Study Group. Eur J Clin Microbiol Infect Dis. 1996;15:718–724. doi: 10.1007/BF01691958. [PubMed] [CrossRef] [Google Scholar]

81. Schaad UB, Heynen G. Evaluation of the efficacy, safety and toleration of azithromycin vs. penicillin V in the treatment of acute streptococcal pharyngitis in children: Results of a multicenter, open comparative study. The Swiss Tonsillopharyngitis Study Group. Pediatr Infect Dis J. 1996;15:791–795. doi: 10.1097/00006454-199609000-00011. [PubMed] [CrossRef] [Google Scholar]

82. Cremer J, Wallrauch C, Milatovic D, et al. Azithromucin versus cefaclor in the treatment of pediatrci patient with acute group A beta-hemolytic streptococcal tonsillopharyngitis. Eur J Clin Microbiol Infect Dis. 1998;17:235–239. [PubMed] [Google Scholar]

83. Tanz RR, Shulman ST, Barthel MJ, et al. Penicillin plus rifampin eradicates pharyngeal carriage of group A streptococci. J Pediatr. 1985;106:876–880. doi: 10.1016/S0022-3476(85)80229-8. [PubMed] [CrossRef] [Google Scholar]

84. Williamson HA. A randomized controlled trial of doxycycline in the treatment of acute bronchitis. J Fam Pract. 1984;19:481–486. [PubMed] [Google Scholar]

85. Tyrrell DAJ. Common Colds and Related Diseases. Baltimore: Williams & Wilkins; 1965. [Google Scholar]

86. Mogabgab WJ. Mycoplasma pneumoniae and adenovirus respiratory illnesses in military and university personnel. Am Rev Respir Dis. 1968;97:345–358. [PubMed] [Google Scholar]

87. Falck G, Heyman L, Gnarpe J, et al. Chlamydia pneumoniae (TWAR): A common agent in acute bronchitis. Scand J Infect Dis. 1994;26:179–187. doi: 10.3109/00365549409011782. [PubMed] [CrossRef] [Google Scholar]

88. Christ-Crain M, Jaccard-Stolz D, Bingisser R, et al. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: Cluster-randomized, single-blinded intervention trial. Lancet. 2004;363:600–607. doi: 10.1016/S0140-6736(04)15591-8. [PubMed] [CrossRef] [Google Scholar]

89. Mainous AGIII, Zoorob RJ, Hueston WJ. Current management of acute bronchitis in ambulatory care: The use of antibiotics and bronchodilators. Arch Fam Med. 1996;5:79–83. doi: 10.1001/archfami.5.2.79. [PubMed] [CrossRef] [Google Scholar]

90. Smucny JJ, Becker LA, Glazier RH, McIsaac W. Are antibiotics effective treatment for q acute bronchitis? A meta-analysis. J Fam Pract. 1998;47:453–460. [PubMed] [Google Scholar]

91. Fahey T, Stocks N, Thomas T. Quantitative systematic review of randomised controlled trials comparing antibiotic with placebo for acute cough in adults. BMJ. 1998;316:906–910. [PMC free article] [PubMed] [Google Scholar]

92. Melbye H, Aasebo U, Straume B. Symptomatic effect of inhaled fenoterol in acute bronchitis: A placebo-controlled double-blind study. Fam Pract. 1991;8:216–222. doi: 10.1093/fampra/8.3.216. [PubMed] [CrossRef] [Google Scholar]

93. Hueston WJ. Albuterol delivered by metered-dose inhaler to treat acute bronchitis. J Fam Pract. 1994;39:437–440. [PubMed] [Google Scholar]

94. Littenberg B, Wheeler M, Smith DS. A randomized controlled trial of oral albuterol in acute cough. J Fam Pract. 1996;42:49–53. [PubMed] [Google Scholar]

Bronchitis vs Upper Respiratory Infection: What’s the Difference?

Respiratory infections are common, especially during the colder months. Two of the most common respiratory infections are bronchitis and upper respiratory infections (URIs). While they share some similarities, there are also some key differences between the two.

What is Bronchitis?

Bronchitis is an inflammation of the bronchial tubes, which are the air passages that lead to the lungs. It can be acute or chronic, with acute bronchitis typically lasting for a few weeks and chronic bronchitis lasting for several months or longer.

The most common cause of acute bronchitis is a viral infection, such as the flu or a cold. Chronic bronchitis is often caused by smoking or exposure to air pollution.

What is an Upper Respiratory Infection?

An upper respiratory infection (URI) is a viral infection that affects the nose, throat, and sinuses. It is also known as the common cold. Symptoms of a URI include a runny or stuffy nose, sore throat, cough, and congestion.

What are the Differences Between Bronchitis and URIs?

While both bronchitis and URIs are respiratory infections, there are some key differences between the two:

  • Location: Bronchitis affects the bronchial tubes, while URIs affect the nose, throat, and sinuses.
  • Symptoms: Bronchitis typically causes a cough that produces mucus, while URIs cause a runny or stuffy nose, sore throat, and congestion.
  • Duration: Acute bronchitis typically lasts for a few weeks, while URIs usually last for a week or two.
  • Cause: Bronchitis is often caused by a viral infection, but can also be caused by smoking or exposure to air pollution. URIs are caused by viral infections.

When Should You See a Doctor?

If you are experiencing respiratory symptoms, it is important to see a doctor to get the right diagnosis and treatment. While most cases of bronchitis and URIs can be treated at home with rest and over-the-counter medications, some cases may require prescription medications or other treatments.

If you are experiencing severe symptoms, such as difficulty breathing or chest pain, seek medical attention immediately.

How Nao Medical Can Help

At Nao Medical, we offer a range of services to help diagnose and treat respiratory infections, including bronchitis and URIs. Our experienced healthcare providers can help you get the right diagnosis and treatment for your respiratory concerns.

We offer same-day appointments, minimal wait times, exceptional and empathetic staff, stunning clinic environments, a technologically driven approach with a comprehensive app, and extensive after-hours virtual care. Book an appointment with us today to get the care you need.

Frequently Asked Questions

What are the symptoms of bronchitis?

The most common symptom of bronchitis is a cough that produces mucus. Other symptoms may include chest discomfort, fatigue, and shortness of breath.

How is bronchitis treated?

Treatment for bronchitis depends on the cause and severity of the infection. Most cases can be treated at home with rest, over-the-counter medications, and plenty of fluids. In some cases, prescription medications may be necessary.

What are the symptoms of an upper respiratory infection?

The symptoms of an upper respiratory infection include a runny or stuffy nose, sore throat, cough, and congestion.

How is an upper respiratory infection treated?

Treatment for an upper respiratory infection typically involves rest, over-the-counter medications, and plenty of fluids. Antibiotics are not effective against viral infections, such as URIs.

When should I see a doctor for a respiratory infection?

If you are experiencing severe symptoms, such as difficulty breathing or chest pain, seek medical attention immediately. Otherwise, it is a good idea to see a doctor if your symptoms last for more than a week or if they are interfering with your daily activities.

Key Takeaways

  • Bronchitis is an inflammation of the bronchial tubes, while upper respiratory infections (URIs) affect the nose, throat, and sinuses.
  • Bronchitis typically causes a cough that produces mucus, while URIs cause a runny or stuffy nose, sore throat, and congestion.
  • If you are experiencing respiratory symptoms, it is important to see a doctor to get the right diagnosis and treatment.
  • Nao Medical offers a range of services to help diagnose and treat respiratory infections, including bronchitis and URIs.

External Links: https://www. cancer.gov/publications/dictionaries/cancer-terms/def/pulmonology, https://www.lung.org/

Disclaimer: The information presented in this article is intended for general informational purposes only and should not be considered, construed or interpreted as legal or professional advice, guidance or opinion.

types, causes, symptoms, signs, diagnosis, treatment, prevention in children and adults

Acute bronchitis

Chronic bronchitis

Occupational bronchitis

Diagnosis

Complications

Treatment 90 003

Prognosis and prevention

Bronchitis is a disease affecting the lower respiratory tract with inflammation of the bronchial mucosa. The inflammatory process can develop only in one part or affect the entire bronchial tree. The main difference from pneumonia is the absence of involvement in the pathological process of the alveoli.

The duration of the disease can be acute and chronic with exacerbations.

The main symptom that allows to suspect a pathology is a cough with sputum, which often causes shortness of breath. Bronchitis is one of the most common reasons for all visits to the doctor.

Acute bronchitis

Many respiratory diseases, and this is SARS and influenza, often occur with manifestations of acute bronchitis. The main pathogens are viruses: rhinoviruses, enteroviruses, coronaviruses, adenoviruses. They account for 90% of all cases. At the same time, rhinoviruses and enteroviruses give a mild course, but coronaviruses and adenoviruses can cause severe complications.

Bacterial causes of bronchitis are much less common and are usually caused by a variety of bacteria. It is noted that during exacerbation of chronic bronchitis, bacteria in the sputum are excreted much more often than in the acute form.

Acute bronchitis can be caused by allergens, as well as exposure to dust, polluted or smoky air.

Bronchitis of the lungs can also be mixed, when infectious and physico-chemical factors are combined, as well as unspecified, when it is not possible to determine what caused the development of the disease.

According to the area of ​​inflammation, bronchitis in children and adults can be divided into:

  • tracheobronchitis;
  • with lesions of medium or small bronchi;
  • bronchiolitis.

The main symptom of acute bronchitis is a cough that occurs with existing manifestations of SARS or another infection. The temperature with bronchitis rises moderately, weakness, a runny nose appear, and the state of health worsens.

At first the cough is dry, there is little sputum, and the coughing attacks become especially painful at night. After 3-4 days, a dry cough is replaced by a wet one, with copious sputum discharge.

In a mild course of the disease, shortness of breath is not observed. If it appears over time, then this indicates damage to the small bronchi, which leads to obstructive bronchitis.

The general condition of the patient during treatment is normalized in a few days, and the cough may persist for another 2-3 weeks. If the temperature does not subside, but only rises, and the general condition noticeably worsens, this indicates the addition of a bacterial infection and the development of complications.

Chronic bronchitis

This diagnosis is made in case of cough with sputum for at least 3 months a year for 2 years or even more. The most common cause of chronic bronchitis is smoking. The main symptoms are a prolonged cough, shortness of breath may join. The cough is usually loose, beginning in the morning after sleep. A little sputum comes out. At the same time, in the cold season and in wet weather, the cough intensifies, but almost completely stops in the summer.

The general state of health does not change in any way, and the cough itself in smokers does not cause any concern and is habitual throughout life.

One of the characteristic features of this disease is the alternation of periods of exacerbation and remission.

People with symptoms of chronic bronchitis are more likely than others to suffer from acute respiratory infections or acute respiratory viral infections, while the risk of damage to the lower sections of the bronchial tree and the development of pneumonia increases several times.

In the future, during the period of exacerbation of bronchitis, the symptoms become more pronounced. The cough is greatly intensified, manifested by seizures, becomes hoarse, tearing the throat, without sputum discharge. Other symptoms appear – constant weakness, fatigue, night sweats. With exertion, shortness of breath begins to appear.

Occupational bronchitis

This type of chronic bronchitis develops in people of certain professions. Such people at work constantly deal with finely dispersed substances that enter the lungs when breathing.

This form of bronchitis, for example, often develops in people associated with the production of asbestos, coal, latex, talc, while working with cotton, silica.

Prolonged contact and inhalation of these substances irritate the lung tissue, accumulate in the lungs, which causes inflammation and coughing. With regular exposure to these factors, in the absence of treatment, chronic obstructive pulmonary disease (COPD) often develops.

Another bronchitis without fever – dust. It is also a chronic occupational lung disease that begins to develop when inhaling air containing an increased concentration of dust. Most often, miners suffer from it.

Diagnosis

Before starting treatment, it is necessary to diagnose bronchitis in order to understand its origin and find the causative agent of the disease (if any).

The main diagnostic procedures are:

  • general blood and urine test;
  • blood biochemistry;
  • X-ray of the chest organs or computed tomography – according to indications for the differential diagnosis of the disease and the identification of probable complications;
  • spirometry or peak flowmetry;
  • if necessary, bronchoscopy or bronchography;
  • ECG, and if necessary – ultrasound of the heart;
  • microbiological sputum analysis.

To exclude hypoxia, especially if bronchiolitis is suspected, it is recommended to monitor saturation.

Differential diagnosis and complications

The symptoms of bronchitis often resemble those of pneumonia. Therefore, first of all, differential diagnosis with this dangerous disease is required. The main differences between pneumonia are respiratory failure, persistent fever, lesions in the lungs on the x-ray.

The most common complication of acute bronchitis is bronchopneumonia. It develops with a decrease in local immunity, lack of proper treatment, as well as with the addition of a bacterial infection.

In the case of chronic bronchitis, the risks of other lung diseases increase: COPD, bronchial asthma, emphysema and bronchiectasis, the likelihood of complications of acute respiratory infections in the form of bacterial pneumonia increases significantly.

Also, against the background of chronic lung diseases, disorders of the cardiovascular system are possible – hypertension, pulmonary hypertension.

Treatment

Therapy will depend on the presence or absence of complications, as well as the general condition of the patient.

Uncomplicated acute viral bronchitis

The therapy is carried out on an outpatient basis. Hospitalization is required only in case of development of respiratory failure and possible accession of pneumonia.

Signs of possible complications will be:

  • high temperature above 38 °C, pain in the chest, and the symptoms do not go away, increase over 2-3 days;
  • the appearance of shortness of breath, shortness of breath begins to develop with minimal physical exertion, at rest;
  • cough with bloody sputum;
  • children’s age;
  • the presence of concomitant serious diseases.

Cough with bronchitis is not so easy to cure. The main goals of treatment are to relieve symptoms of the disease and maintain immunity. Bronchitis without coughing is very rare.

Today, the most effective methods of treating acute bronchitis of viral etiology are:

  • antivirals;
  • paracetamol or ibuprofen – in case of temperature increase above 38 °C;
  • copious warm drink;
  • frequent airing of the room, the creation of good indicators of humidity and temperature. This noticeably facilitates breathing and improves the excretion of sputum;
  • smoking cessation;
  • mucolytic or antitussive drugs (depending on the type of cough).

Antibiotics for bronchitis of viral origin are not prescribed, since they are absolutely ineffective.

Acute obstructive bronchitis

Therapy of this type of inflammation has some features. Treatment is recommended to be carried out using a device that sprays the drug into the respiratory tract – a nebulizer.

For inhalation, solutions of mucolytics (ambroxol, acetylcysteine), bronchodilators (fenoterol and ipratropium bromide) are used. They are mixed with saline and help prevent the development of bronchial edema, which is important for preventing shortness of breath. In some cases, inhaled corticosteroids may be recommended for treatment. The duration of the course and the frequency of use of drugs are recommended only by a doctor.

Bacterial bronchitis

In the treatment of this type of disease, it is recommended to use antibacterial agents that are prescribed by the attending physician. A number of antibiotics can be prescribed as inhalations through a nebulizer. In addition, symptomatic therapy is recommended to improve sputum discharge.

A special group are patients at risk – those who are over 75 years of age, have severe comorbidities or are using immunosuppressive therapy. For them, the dosage of drugs is prescribed individually.

Chronic bronchitis

With the development of this course of the disease, long-term and individually selected treatment is required. There is no single cure for bronchitis for everyone: each treatment plan is made depending on the age of the patient, the symptoms present, the severity of their manifestation and the duration of the course.

In case of exacerbation and the appearance of purulent sputum, antibiotics can be prescribed, but this is done only according to the results of a sputum sensitivity test. They help to fight sputum with bronchitis, drugs that thin it and help to cough up.

If chronic bronchitis is allergic, antihistamines are prescribed. Recommended warm plentiful alkaline drink, breathing exercises, physiotherapy. Vitamin and mineral complexes may be prescribed.

After an exacerbation, a spa treatment is recommended. It is also important to identify and eliminate the provoking factor that led to the development of the disease in its chronic form.

Prognosis and prevention

With proper and timely treatment of bronchitis, the prognosis is favorable. Usually, full recovery occurs within 2-3 weeks from the onset of symptoms. However, a cough in a quarter of all patients can persist for another one, and in some cases two months.

Effective measures to prevent bronchitis include:

  • washing hands with soap, rinsing the nose and mouth with saline solution;
  • vaccination against bronchopulmonary infections;
  • smoking cessation;
  • proper nutrition with adequate protein content;
  • hardening.

It is also advisable to air the room hourly, do wet cleaning, control humidity and air temperature.

The author of the article:

Ivanova Natalya Vladimirovna

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