Still coughing after antibiotics for bronchitis: Acute Bronchitis – Persistent Cough
That persistent cough may be bronchitis
If you’ve been hacking away for two weeks or longer, with or without a cold, you may have bronchitis.
A lingering cough is the most common symptom of bronchitis, according to Yarden Tahan, MD, an HonorHealth family medicine physician. Bronchitis usually is caused by a virus. It causes inflamed airways, which results in a cough.
“Unfortunately, you can’t avoid it because the virus can be in the air you breathe or on the surfaces you touch. It can be transmitted by close family members or strangers in the grocery store,” she said.
In addition to viral infections, bronchitis can be caused by a bacterial infection, tobacco smoke, air pollution, fumes, vapors and dust.
Bronchitis can be either acute or chronic, depending on how long you’ve been coughing and what other symptoms arise.
If you have acute bronchitis, your cough generally lasts fewer than six weeks, with about three weeks being the most common.
If you have chronic bronchitis, your cough generally lasts longer than six weeks because the airways are repeatedly irritated by one or more of the causes listed above, especially tobacco smoke.
In addition to persistent coughing, you may have these symptoms:
- Tightness in your chest
- Mucus when you cough
- Body aches
- Stuffy nose and sinuses
- Sore throat
- Fever and/or chills
Either type of bronchitis can go away naturally by practicing self-care at home, including:
- Washing your hands frequently.
- Sanitizing surfaces you touch, such as light switches and door knobs.
- Using over-the-counter medications, including cough drops and pain relievers.
- Drinking lots of fluids, including tea with honey.
- Staying at home to avoid spreading the disease.
It’s not always necessary to see your doctor if you’re a young, healthy person with no history of lung disease and no difficulty breathing. But it can be useful to be evaluated so your doctor can ensure you don’t have pneumonia.
Watch for pneumonia
Pneumonia is suspected in a patient who comes in with cough but who also has these symptoms:
- Fast heartbeat
- Fast breathing
- Difficulty breathing
- Abnormal breath sounds
And, partially because of the decline in vaccination rates, whooping cough is also a possibility for a patient with a persistent cough, particularly one that sounds like a bark or whooping noise. Whooping cough also is often accompanied by vomiting after a cough.
“Physicians don’t recommend antibiotics for bronchitis because it’s usually caused by a virus,” Dr. Tahan said. “The negative side effects from the antibiotics — yeast infections, diarrhea, C. diff (clostridium difficile) — are more concerning than the minimal benefit you would receive from antibiotic use.”
Bronchitis can create an environment in the lungs that’s hospitable to pneumonia in some cases — especially in very young or older patients, or in those who are immunocompromised, have existing lung disease or who smoke.
If you have one of these risk factors or are not getting better after a few weeks, you should see your physician. If you have any pneumonia symptoms, you should see your physician sooner rather than later.
Bronchitis is so common that Dr. Tahan sees several bronchitis patients each week, especially during the winter. She advises supportive care, not more care, to treat what’s happening first.
Acute Bronchitis | Johns Hopkins Medicine
What is acute bronchitis?
Bronchitis is inflammation of the breathing tubes. These airways are called bronchi. This inflammation causes increased mucus production and other changes. Although there are several different types of bronchitis, the most common are acute and chronic. Acute bronchitis may also be called a chest cold.
Most symptoms of acute bronchitis last for up to 2 weeks. The cough can last for up to 8 weeks in some people. Chronic bronchitis lasts a long time. It is more common among smokers.
What causes acute bronchitis?
Acute bronchitis is usually caused by a viral infection. This is most often the same viruses that cause colds and the flu. It may also be caused by a bacterial infection, or by physical or chemical agents that are breathed in. These may include dusts, allergens, and strong fumes, including those from chemical cleaning compounds or tobacco smoke.
Acute bronchitis may come after a common cold or other viral infections in the upper respiratory tract. It may also occur in people with chronic sinusitis, allergies, or those with enlarged tonsils and adenoids. It can be serious in people with lung or heart diseases. Pneumonia is a complication that can follow bronchitis.
What are the symptoms acute bronchitis?
The following are the most common symptoms of acute bronchitis. However, each person may experience symptoms differently. Symptoms may include:
- Back and muscle pain
- Cough, first dry (non-productive), later, a lot of mucus is produced
- Chest soreness
- Feeling tired and achy
- Runny nose
- Slight fever
- Shortness of breath
- Sore throat
- Watery eyes
The symptoms of acute bronchitis may look like other conditions or medical problems. Talk with a healthcare provider for a diagnosis.
How is acute bronchitis diagnosed?
Healthcare providers can often diagnose acute bronchitis by taking a medical history and doing physical exam. Tests may be done to rule out other diseases, such as pneumonia or asthma. Any of these tests may be used to help confirm a diagnosis:
- Chest X-rays. A test that uses invisible radiation beams to make images of internal tissues, bones, and organs, including the lungs.
- Arterial blood gas. This blood test is used to analyze the amount of carbon dioxide and oxygen in the blood.
- Pulse oximetry. An oximeter is a small machine that measures the amount of oxygen in the blood. To get this measurement, a small sensor is taped or clipped on a finger or toe. When the machine is on, a small red light can be seen in the sensor. The sensor is painless and the red light does not get hot.
- Cultures of nasal discharge and sputum. Testing the sputum you cough up or swab from your nose may be done to find and identify the microorganism causing the infection.
- Pulmonary function tests. These are tests that help to measure the ability of the lungs to move air in and out of the lungs. The tests are usually done with special machines that you breathe into.
How is acute bronchitis treated?
Acute bronchitis is usually mild and does not cause complications. The symptoms often resolve on their own and lung function goes back to normal.
In most cases, antibiotics are not needed to treat acute bronchitis. That’s because most of the infections are caused by viruses. Antibiotics are not effective against viruses. If it has progressed to pneumonia, then antibiotics may be necessary.
Treatment is aimed at treating the symptoms, and may include:
- Avoiding exposure to secondhand smoke
- Cough medicine
- Humidifying the air
- Increased fluid intake
- Pain relievers and fever reducers, such as acetaminophen (Tylenol)
- Quitting smoking
Avoid antihistamines because they dry up the secretions and can make the cough worse.
What are the complications of acute bronchitis?
Acute bronchitis can worsen and progress to chronic bronchitis or pneumonia. If this happens, a different treatment may be necessary.
Can bronchitis be prevented?
Acute bronchitis can’t always be prevented. However, there are shots you can get to prevent its complications, such as pneumonia.
Check with your healthcare provider about getting the flu and pneumococcal shots. Getting a flu shot every year can help prevent both the flu and pneumonia. The pneumococcal shot can protect you from a common form of bacterial pneumonia.
Anyone can get pneumococcal disease. However, children younger than age 2, adults ages 65 and older, people with certain medical conditions, and smokers are at the highest risk.
When should I call my health care provider?
Most often, bronchitis resolves on its own. If your symptoms worsen or don’t get better over time, call your healthcare provider.
- Bronchitis is inflammation of the breathing tubes. These airways are called bronchi. There are several different types of bronchitis. The two most common are acute and chronic.
- Acute bronchitis is usually caused by the same viruses that cause colds and the flu. It may also be caused by a bacterial infection, or by physical or chemical agents that are breathed into the lungs.
- The most common symptoms for acute bronchitis include cough, chest soreness, runny nose, feeling tired and achy, headache, chills, slight fever, and sore throat.
- Healthcare providers can often diagnose acute bronchitis by taking a medical history and doing physical exam. Blood tests, breathing tests, and imaging tests may also be used.
- In most cases, antibiotics are not needed to treat acute bronchitis. If it progresses to pneumonia, then antibiotics may be necessary. Treatment is aimed at managing the symptoms.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your healthcare provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your healthcare provider if you have questions.
Chronic Bronchitis: Treatment, Diagnosis, Symptoms, Causes
Mid-January this year I started a cough with tickle in my throat. This continued unchanged until early February then cough with some mucus began worsening. The week prior to February 10, I had begun to cough hard and often, with increasing mucus. Cough continued, improving then worsening. I was taking a Tussin DM cough syrup and Mucinex cough or cold and flu. This kept the cough bearable during the day and with the pills every 12 hours and cough syrup every 4, I could sleep in 4 hour stints. It would get better then worsen. February 22 I had to fly 3 hours from Indiana to a ski resort in Colorado. The day of the flight the cough worsened tremendously and mucus increased, thickened and got greener. I tried hard not to cough on the flight and coughed into my wrap when I did. Some speculate the altitude change worsened it, I don’t know. Our 3rd day there, I had chills and a fever of about 99.1. I was ready to go to a clinic but my daughter used the internet to diagnose bronchitis, I decided I could tough that out. Mucus was profuse, I had a lot of sinus mucus in addition. I tried to keep my distance from family members in the condominium and protect fellow passengers on the return fight. (Happily my family did not catch anything from me.) Back home on February 26, it seemed a little better. I was still using my OTC regimen. From Monday to Friday it worsened significantly until my cough was so bad and so much mucus I couldn’t breathe at times. I’m not sure if the fever came and went or was steady but when I checked it’s be under 100. Scared, I finally went to a clinic. I was diagnosed with bronchitis, not yet pneumonia, but close. I was given an antibiotic, albuterol inhaler and could have had prednisone but turned it down. I began improvement and the inhaler saved me from uncontrollable coughing spasms and extremely difficulty to breathe. It was horrible, it is hard to describe. The antibiotic began to work immediately and I was well on the road to mending soon. The cough lessened, the mucus has lessened significantly and grown almost milky with little yellow. But on March 26, close to 2 months since the initial cough and almost a month since bronchitis diagnosis, I am using the inhaler once or twice in 24 hours and no other medicine but still have a deep uncontrollable tickling cough. I have little energy and tire easily but since it has been such a long time I wonder if the bronchitis is making me tired or if I am just lazy using it as a cop out. I wish I knew what is going on and if I’m getting well or teetering on the verge of worsening again.
Treating acute bronchitis – InformedHealth.org
Acute bronchitis usually goes away on its own. Until that happens, several things can help to relieve the cough and cold symptoms somewhat. Antibiotics generally don’t help in the treatment of acute bronchitis so they aren’t recommended for this purpose.
Acute bronchitis is especially common in the autumn and winter: The first signs are a stuffy nose, headache and sore throat. After that, a persistent cough develops that can last for weeks. Then it’s time to “sit back and wait” for the acute bronchitis to go away on its own. You don’t have to take any medication. Antibiotics generally don’t help in the treatment of acute bronchitis because it is usually caused by viruses.
Various medications can be used to treat the cough and cold symptoms – but only a few of them can noticeably influence the course of the illness. The costs of most of the medications aren’t covered by health insurers.
Is it worth it to use mucus-loosening medicine (expectorants)?
“Expectorants” is the medical term used to describe medications that
This is meant to make it easier to cough up the phlegm and relieve the cough. Based on the research in this area so far, it isn’t clear whether these medications actually help in the treatment of acute bronchitis. Expectorants should only be used if the phlegm can be coughed up.
What do cough suppressants (antitussives) do?
Cough suppressants (antitussives) don’t act upon the inflamed mucous membranes in the bronchi. Instead, they aim to suppress the urge to cough, so they are rarely used in the treatment of acute bronchitis. Typical examples of suppressants include codeine and dextromethorphan.
Cough suppressants should only be used in the treatment of severe dry coughs, for a maximum period of two weeks. They shouldn’t be used in the treatment of productive (“wet”) coughs: If the urge to cough is suppressed, the phlegm won’t be coughed up and out of the lungs.
Besides, there haven’t been any studies on the benefits and drawbacks of cough suppressants in the treatment of acute bronchitis. The few studies so far have only looked into their effects in simple colds, throat infections and sinusitis. These studies showed the following:
Codeine doesn’t help in the treatment of acute chest colds in adults, children or teenagers. Children under the age of twelve generally shouldn’t be prescribed codeine or medications that contain codeine. The same is true for breastfeeding mothers.
- Dextromethorphan can somewhat soothe coughs associated with upper respiratory tract infections in adults only, at least for a short while after it is taken. People with lung conditions like asthma or COPD shouldn’t take dextromethorphan. The possible side effects include dizziness and gastrointestinal (stomach and bowel) problems.
Codeine has to be prescribed by a doctor, whereas medications containing dextromethorphan are also available from pharmacies without a prescription.
How effective are herbal products?
Various herbal products are available for the treatment of acute bronchitis. Some of them are based on combinations of different active ingredients. Examples include Pelargonium, primrose, thyme, eucalyptus and ivy extracts. Studies on these products suggest that they can somewhat soothe acute bronchitis coughs and make it easier to cough up phlegm. The possible side effects include stomach and bowel problems. Statutory health insurers in Germany generally don’t cover the costs of these products.
Other herbal products – such as those used in traditional Chinese medicine (TCM) – have hardly been tested in high-quality studies. So it isn’t known whether they can help. But they, too, can have side effects.
Do bronchodilators work?
Bronchodilators (medications to widen the airways) are normally used in the form of an inhaler for the treatment of lung conditions that cause the airways to narrow, such as asthma and COPD. They shouldn’t be used to treat acute bronchitis in which the airways aren’t narrowed, particularly because they wouldn’t help.
Which medications can help relieve other symptoms?
Especially in the early stage of acute bronchitis, other symptoms like headaches, a sore throat, an earache or joint pain may be caused by the cold or flu viruses. These symptoms can then be treated using pain-relieving and fever-lowering medication such as acetaminophen (paracetamol) or non-steroidal anti-inflammatory drugs (NSAIDs).
Acetaminophen (paracetamol) and NSAIDs, which include ibuprofen and acetylsalicylic acid (the drug in e. g. Aspirin), are available from pharmacies without a prescription. They come in the form of tablets, suppositories and syrups. Acetylsalicylic acid isn’t suitable for children under the age of twelve who have a viral infection with a fever. This is because it can lead to severe brain and liver damage (Reye’s syndrome), although that is rare.
What else can you do?
Particularly in the first few days of the illness, it is important to take the time to rest, and avoid strenuous physical activity and sports. People are often advised to drink a lot of fluids to help loosen the mucus in their bronchi (lungs). But there are no suitable studies on whether “drinking a lot of fluids” is better than “drinking normal amounts,” or may even be harmful.
Honey can soothe coughs – either eaten on its own or stirred into a warm drink. Studies in children suggest that honey can soothe coughs associated with upper respiratory tract infections. But children under the age of one shouldn’t eat honey because they sometimes react sensitively to certain bacteria in it.
Smokers who have acute bronchitis can go easy on their lungs by trying not to smoke, or by smoking a lot less.
Why aren’t antibiotics recommended?
Antibiotics are drugs that kill or prevent the growth of bacteria. Acute bronchitis is usually caused by viruses, though, so antibiotics won’t help.
Many studies have shown that antibiotics hardly affect the course of the illness. In the studies, antibiotics reduced the duration of the cough by half a day on average. But they also caused side effects such as diarrhea, nausea or a skin rash in about 3 out of 100 people.
The frequent use of antibiotics to treat respiratory infections can also lead to the development of resistant bacteria. That can result in some medications no longer being effective against certain bacteria. So antibiotics aren’t recommended for the treatment of acute bronchitis.
Some people have a higher risk of acute bronchitis leading to more serious complications (e.g. pneumonia), for instance due to a weak immune system, a severe lung or heart condition, or old age. Treatment with antibiotics may then be a good idea, in order to prevent complications.
- Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM). DEGAM-Leitlinie Nr. 11: Husten. AWMF-Registernr. 053-013. February, 2014.
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Because IQWiG is a German institute, some of the information provided here is specific to the
German health care system. The suitability of any of the described options in an individual
case can be determined by talking to a doctor. We do not offer individual consultations.
Our information is based on the results of good-quality studies. It is written by a
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Bronchitis – Symptoms and causes
Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. People who have bronchitis often cough up thickened mucus, which can be discolored. Bronchitis may be either acute or chronic.
Often developing from a cold or other respiratory infection, acute bronchitis is very common. Chronic bronchitis, a more serious condition, is a constant irritation or inflammation of the lining of the bronchial tubes, often due to smoking.
Acute bronchitis, also called a chest cold, usually improves within a week to 10 days without lasting effects, although the cough may linger for weeks.
However, if you have repeated bouts of bronchitis, you may have chronic bronchitis, which requires medical attention. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD).
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For either acute bronchitis or chronic bronchitis, signs and symptoms may include:
- Production of mucus (sputum), which can be clear, white, yellowish-gray or green in color — rarely, it may be streaked with blood
- Shortness of breath
- Slight fever and chills
- Chest discomfort
If you have acute bronchitis, you might have cold symptoms, such as a mild headache or body aches. While these symptoms usually improve in about a week, you may have a nagging cough that lingers for several weeks.
Chronic bronchitis is defined as a productive cough that lasts at least three months, with recurring bouts occurring for at least two consecutive years.
If you have chronic bronchitis, you’re likely to have periods when your cough or other symptoms worsen. At those times, you may have an acute infection on top of chronic bronchitis.
When to see a doctor
See your doctor if your cough:
- Lasts more than three weeks
- Prevents you from sleeping
- Is accompanied by fever higher than 100.4 F (38 C)
- Produces discolored mucus
- Produces blood
- Is associated with wheezing or shortness of breath
Acute bronchitis is usually caused by viruses, typically the same viruses that cause colds and flu (influenza). Antibiotics don’t kill viruses, so this type of medication isn’t useful in most cases of bronchitis.
The most common cause of chronic bronchitis is cigarette smoking. Air pollution and dust or toxic gases in the environment or workplace also can contribute to the condition.
Factors that increase your risk of bronchitis include:
- Cigarette smoke. People who smoke or who live with a smoker are at higher risk of both acute bronchitis and chronic bronchitis.
- Low resistance. This may result from another acute illness, such as a cold, or from a chronic condition that compromises your immune system. Older adults, infants and young children have greater vulnerability to infection.
- Exposure to irritants on the job. Your risk of developing bronchitis is greater if you work around certain lung irritants, such as grains or textiles, or are exposed to chemical fumes.
- Gastric reflux. Repeated bouts of severe heartburn can irritate your throat and make you more prone to developing bronchitis.
Although a single episode of bronchitis usually isn’t cause for concern, it can lead to pneumonia in some people. Repeated bouts of bronchitis, however, may mean that you have chronic obstructive pulmonary disease (COPD).
To reduce your risk of bronchitis, follow these tips:
- Avoid cigarette smoke. Cigarette smoke increases your risk of chronic bronchitis.
- Get vaccinated. Many cases of acute bronchitis result from influenza, a virus. Getting a yearly flu vaccine can help protect you from getting the flu. You may also want to consider vaccination that protects against some types of pneumonia.
- Wash your hands. To reduce your risk of catching a viral infection, wash your hands frequently and get in the habit of using alcohol-based hand sanitizers.
- Wear a surgical mask. If you have COPD, you might consider wearing a face mask at work if you’re exposed to dust or fumes, and when you’re going to be among crowds, such as while traveling.
Chest infections | Asthma UK
How do chest infections affect asthma symptoms?
How can I tell the difference between asthma symptoms and a chest infection?
How do I take care of my asthma if I have a chest infection?
Diagnosing a chest infection
Treatment for a chest infection
I’ve had treatment for my chest infection, but I’m still having symptoms. What should I do now?
How can I help prevent another chest infection?
How do chest infections affect asthma symptoms?
If you have asthma, you can have an increased risk of getting a chest infection. Chest infections can also make your asthma symptoms worse, as they make your airways inflamed.
Asthma causes inflammation in your airways. If you get a chest infection like pneumonia or bronchitis, it can make this inflammation worse, as well as causing:
How can I tell the difference between asthma symptoms and a chest infection?
Some chest infection symptoms can feel like asthma symptoms. This can make it hard to tell if you have a chest infection, or your asthma symptoms are getting worse.
If you have some, or all, of these symptoms, you might have a chest infection:
- A chesty wet cough, with yellow or green phlegm
- Wheezing or breathlessness
- Chest pain or discomfort
- A high temperature of 38 degrees or above
- Aching muscles
A high temperature can also be a symptom of COVID-19, so it’s important that you get a test as soon as possible if you have any of the main symptoms. For more advice, check the NHS website.
How do I take care of my asthma if I have a chest infection?
If you get a chest infection, the most important things you should do are:
This will lower the chances of you having an asthma attack caused by your chest infection.
It’s really important you take your preventer inhaler in the right way, to make sure the medicine gets straight to your lungs. Watch a video on how to use your inhaler properly.
If your asthma symptoms are really bothering you, you can also take your reliever inhaler when you get asthma symptoms. If you have a chest infection, you may need to use your reliever inhaler more than normal.
This should help in the short term, but if you are needing to use your inhaler more than normal, get urgent medical advice. You should also get medical advice if your reliever inhaler isn’t lasting for four hours.
Diagnosing a chest infection
If you have asthma and think you may have a chest infection, make sure you tell your doctor:
- about your asthma symptoms
- how well your inhalers are working
- what your peak flow readings are showing
- if your peak flow improves after taking your inhaler.
If you’ve not been diagnosed with asthma and you’ve had a cough for more than three weeks, it could be that you have asthma or another lung condition, rather than a chest infection. It’s important to get the right diagnosis, so you get the right treatment.
Video: Chest infections and asthma
Asthma UK nurse Suzanne explains how to stay well if you’ve got asthma and you get a chest infection
Chest infections can be a real pain – making you feel horrible…
…and getting in the way of work and your social life. If you have asthma, they can also make your asthma symptoms worse.
…and getting in the way of work and your social life. If you have asthma, they can also make your asthma symptoms worse.
That’s why the best thing you can do is to take your preventer inhaler, as it’s made to calm down the inflammation in your airways. Taking it daily as prescribed will reduce your asthma symptoms and make your chest infection a lot more bearable
Chest infections have similar symptoms to asthma like coughing, wheezing and breathlessness.
This can make it hard to tell whether you have a chest infection or if your asthma symptoms are getting worse.
The biggest indicator of a chest infection is a high temperature – of 38 degrees or above.
If you have some, or all, of these symptoms, it might be a chest infection:
A temperature of 38 degrees or above
A chesty wet cough
Lots of yellow or green phlegm that is thick, and may be smelly”
Chest pain or discomfort
If your chest infection is making your asthma symptoms worse. Sometimes your doctor might give you a course of steroids to treat the flare up.
If your reliever medication isn’t lasting for four hours
If your asthma is waking you at night
If you feel like your chest infection has cleared up, but you’re still having asthma symptoms, such as a dry cough or breathlessness.
Treatment for a chest infection
If your chest infection is making your asthma symptoms worse, your doctor might give you a course of steroid tablets or make changes to your inhaled medicines to treat the flare up.
Your doctor will probably be able to tell whether you need antibiotics, although they might send a sample of your phlegm away to be tested.
If they’re not sure, they might give you a ‘delayed prescription’ of antibiotics, meaning you should only take them if you don’t feel better in a few days. Most chest infections are caused by viruses, which can’t be treated with antibiotics.
Viral chest infections can’t be treated by antibiotics. It can be tempting to ask for antibiotics ‘just in case’ because you want to get rid of your symptoms. But it’s important that you only take antibiotics if you really need them.
I’ve had treatment for my chest infection, but I’m still having symptoms. What should I do now?
The cough from a chest infection is usually the last symptom to go and could last up to three weeks, even after treatment. If you find you’ve still got a cough after your chest infection has cleared up, this might be a sign that your airways are still inflamed, so it’s worth seeing your doctor.
You should also see a doctor if:
- your asthma is waking you at night
- you feel like your chest infection has cleared up, but you’re still having asthma symptoms three or more times a week
- your chest infection doesn’t get completely better after a course of treatment.
You should phone 111 or 999 if you:
- feel your chest infection symptoms get worse at any point
- develop a fever
- start getting more breathless
- develop chest pains
- start coughing up blood.
How can I help prevent another chest infection?
It’s impossible to completely avoid chest infections, but there are a few things you can do to reduce your risk of getting them.
Take steps to keep healthy
You can do this by making a few lifestyle changes, such as:
Avoid colds and flu
Try to protect yourself from other infections like colds and flu, as this will make a chest infection less likely. Our page on colds and flu has lots of practical ideas you can follow to protect yourself against them.
Last updated November 2020
Next review due November 2023
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Antibiotics don’t improve cough in acute bronchitis
Acute bronchitis with cough is overwhelmingly often due to viral infection, but that doesn’t stop coughers from seeking antibiotics, or their doctors from obligingly prescribing them. Most patients who ask for antibiotics get them, and the millions of excess antibiotic doses worldwide each year are believed to contribute to rising antibiotic resistance. Doctors seem almost helpless to deny patients a seemingly harmless treatment they’re so sure they need, and there’s always an arguable chance antibiotics might help.
Discolored sputum is often considered evidence by both patients and doctors that an infection is bacterial, and doctors are 3 times more likely to prescribe antibiotics if yellow or green sputum is described with an acute cough. But although people with chronic bronchitis (e.g., COPD) often have bacteria present in their sputum during acute exacerbations, in people with acute cough without chronic respiratory disease, the “green sputum = I need antibiotics” logic does not apply. In otherwise healthy people, green sputum is often present during viral infections.
That said, a Cochrane analysis of randomized trials concluded that antibiotics did lead to about a half-day faster resolution of cough from acute bronchitis, on average, but one in 17 patients also had a significant antibiotic side effect. Over-the-counter antitussive medicines don’t seem to work for acute cough.
Considering its status as the #1 stated reason for primary care visits, cough due to acute bronchitis has been poorly studied overall. Carl Llor et al undertook a large-ish randomized trial to answer the question, does discolored sputum really mean antibiotics will help an acute cough get better?
What They Did
416 adults with acute cough (< 1 week) with discolored sputum but no underlying lung disease (COPD, asthma, etc) or recent antibiotic/prednisone use were randomized to receive either amoxicillin/clavulanate (Augmentin) 500/125 mg, ibuprofen 600 mg, or placebo three times daily in a 1:1:1 ratio. Authors closely observed adherence and followed up at ~3 days and ~12 days. Days of frequent coughing, the primary outcome, were recorded in a symptom diary. The physicians were not 100% blinded, because the pills were different appearances, but they were provided in sealed and obscured packages.
What They Found
There was no difference in number of days with frequent coughing between treatment arms. In other words, neither antibiotics (Augmentin) or ibuprofen improved cough in patients with acute bronchitis, all of whom also had discolored sputum.
Patients coughed for about 2 weeks total. Those taking ibuprofen had 9 days of frequent coughing vs. 11 for antibiotics and placebo, and also fewer total days of cough, but this wasn’t statistically significant.
Those taking antibiotics had 16 adverse events, including a GI hemorrhage, compared to 7 with ibuprofen (mostly GI upset, no bleeding) and 4 with placebo.
What It Means
This well-done study casts doubt on the previously mentioned Cochrane analysis suggesting antibiotics improve cough, which included only 275 patients total.
GRACE, the largest trial yet testing antibiotics for acute bronchitis with purulent sputum in 2,060 adults and published in February 2013, showed amoxicillin did not reduce cough symptoms or severity. Antibiotics did prevent “new or worsening” symptoms in an absolute 3% of patients. However, with nausea, rash, and GI upset, the number needed to harm was 21. One patient taking amoxicillin developed anaphylaxis.
Unfortunately, these studies tell us nothing about azithromycin, which may be more commonly prescribed in the U.S. today for acute cough from bronchitis than amoxicillin. Authors say they did not select azithromycin because “we wanted to exclude the possibility of clinical improvement due to an anti-inflammatory effect.” But do patients care whether they are getting better from an antibacterial or an anti-inflammatory effect of a medicine? And should we, as their doctors?
Azithromycin probably has fewer GI side effects and anaphylaxis than amoxicillin, as well. However, azithromycin was no better than vitamin C at reducing cough from acute bronchitis among 220 patients in a 2002 randomized trial. If we got a larger trial testing azithromycin to confirm those results, combined with its sudden cardiac death risk data and the poor efficacy here from amoxicillin, there just might be enough evidence-based armor for us pathologically patient-pleasing doctors to feel confident saying “no” — and I mean it this time — when patients demand antibiotics for acute cough from acute bronchitis and the common cold.
Clinical Takeaway: Consider offering ibuprofen instead of antibiotics as first-line therapy for patients insisting on treatment for cough due to acute bronchitis. NSAIDs might help — and at minimum, will allow a few days for natural recovery to reassure patients they’re getting better without antibiotics.
Carl Llor et al. Efficacy of anti-inflammatory or antibiotic treatment in patients with non-complicated acute bronchitis and discoloured sputum: randomised placebo controlled trial. BMJ 2013; 347:f5762.
90,000 Antibiotic treatment for people with acute bronchitis
We wanted to know if antibiotics improve outcomes in people with acute bronchitis. We also assessed the potential adverse effects of antibiotic therapy.
Acute bronchitis is a clinical diagnosis (based on the medical signs and symptoms reported by patients) of an acute cough that may or may not be accompanied by coughing up mucus or phlegm.Acute bronchitis can be caused by viruses or bacteria. Symptoms usually last two weeks, but can last up to eight weeks. Antibiotics are usually prescribed to treat acute bronchitis, but they can have adverse effects, such as nausea and diarrhea, and cause more serious reactions in those with allergies. There is no practical test to distinguish between bacterial and viral bronchitis.
We included randomized controlled trials comparing any antibiotic therapy with placebo or no treatment in people with acute bronchitis or acute productive cough without chronic lung disease.We included 17 trials with 5099 participants. Co-treatment with other drugs to relieve symptoms was allowed if they were given to all study participants.
Our evidence is current to 13 January 2017.
We found limited evidence of clinical benefit to support the use of antibiotics for acute bronchitis. Some people who were treated with antibiotics recovered slightly faster with fewer cough-related outcomes.However, this difference may not be practical as it amounts to a half day difference over a period of 8-10 days. There was a small but significant increase in adverse effects in people treated with antibiotics. Among the most common reported side effects were nausea, vomiting, diarrhea, headache, and rash.
This review suggests that there is limited patient benefit in antibiotic use for acute bronchitis without comorbidities.More research is needed on the impact of antibiotic use on acute bronchitis in frail elderly people with multiple chronic conditions that may not have been included in existing trials. Antibiotic use needs to be considered in the context of potential side effects, medicalization of the self-resolving condition, the cost of antibiotic treatment and, in particular, the associated harm at the population level due to increased antibiotic resistance.
Quality of evidence
The quality of these trials was generally good, especially for more recent studies.
90,000 7 Cough Treatment Mistakes That Can’t Get You Well
More helpful tips for treating a cold from Fluifort * can be found here.
1. A cough can be left untreated: sooner or later it will pass by itself
If we are talking about a cough against the background of a cold, that is, about a viral infection, then we are talking about an acute cough.In general, yes: this symptom, like a runny nose, goes away in 2-3 weeks. And if the cough does not go away, then it is called chronic – and so he can exhaust his victim for months. This is a vicious circle, from which it is difficult to break out.
Due to constant coughing, the bronchi become hypersensitive and react to any irritating factor. For example, frosty or too dry air, physical activity (that is, rapid breathing), pungent odors. And for any reason, you go into a cough. It is much more difficult to get yourself out of this state than to recover in time.
2. Cough should be treated with antibiotics
Antibiotics are prescribed by a doctor. And only for the treatment of a bacterial infection. In most cases, a cold cough is caused by viruses. Bacteria can join later, and then there is a risk of bronchitis, pneumonia and other complications.
One of the best things you can do to prevent bacterial infections is to keep sputum from stagnating in the trachea and bronchi. The action of mucolytics is directed to this.
For example, Fluifort * cough syrup * not only reduces the severity of wet coughs, but also speeds up the excretion of sputum – such timely measures may allow you to recover without antibiotics and not transfer your acute cough to a chronic status.
3. The room must be warm and dry
Objectively, temperature and humidity do not critically affect the speed of recovery. It is much more important to observe the general rules of hygiene: daily wet cleaning and airing. But the quality of life depends on temperature and humidity – whether you will suffer from your ARVI or enjoy a legal vacation on sick leave. Therefore, the atmosphere in the room should be comfortable for you.
In case of bronchial hyperreactivity, too dry air can provoke coughing fits.In addition, it promotes “drying”, thickening of phlegm and makes it difficult to cough up. As a result, the condition becomes chronic. The hospital is closed because there are no more signs of an acute illness, and in the cold (which also irritates hyperreactive bronchi) you run to cough to work.
4. With a wet cough, you can use antitussive drugs
Everyone knows that this should not be done: a cough is an unconditioned reflex that allows you to push out everything harmful and unnecessary from the respiratory tract.But sometimes it is so exhausting that you want to drown it at least for the night. Or at least at work. And this is dangerous.
Antitussives act on receptors or directly on the cough centers of the brain and thus suppress the reflex. But if phlegm gurgles in the bronchi, and the body is trying to get rid of it, then interfering with it is a crime against itself. Stagnation of infected mucus can lead to bronchitis and pneumonia. But the good news is that mucolytics are just as good as antitussives, and they can provide you with restful sleep and the loyalty of your officemates.
One of the leading causes of chronic cough is postnasal drip, when mucus from the nose flows down the back of the throat, irritating the cough receptors. The mucolytic preparation Fluifort * suppresses mucus production and facilitates its passage. Therefore, a coughing fit will not wake you up in the middle of the night or interrupt your workflow too often.
5. If antibiotics are prescribed, then it makes no sense to use expectorant drugs
Let’s not be confused: a bacterial infection is a disease, a cough is a symptom.Antibiotics are prescribed to you to destroy the cause of the disease. And symptomatic therapy in different cases can enhance their therapeutic or, conversely, side effects.
If the doctor has prescribed antibiotics, be sure to tell him what other medications you are taking. For example, in the instructions for expectorant drugs based on acetylcysteine, incompatibility with antibacterial agents is directly spelled out. And carbocisteine lysine salt, which is contained in the “Fluifort” *, on the contrary, enhances the effectiveness of treatment, since it increases the concentration of the antibiotic in the focus of inflammation.
6. Herbal preparations are safer than chemistry
The effectiveness of herbal medicines is due to the content of the active substance in them, which can be synthesized in laboratory conditions. The problem is that it is impossible to provide the exact dosage of this component in the plant.
In modern synthetic preparations, the doses of the active substance are very precisely selected, and undesirable side effects are minimized.
7. Banks and mustard plasters are the best remedy for cough
Just make a reservation: no warming up procedures can be used for cancer and cardiovascular diseases.In other cases, it is possible. The question is – does this make sense?
Cans and mustard plasters, as well as mustard in socks or a vodka wrap around the neck are referred to as distraction therapy. A Soviet-trained man is not morally ready to just lie there and wait for the body to cope with the virus on its own. He wants to be actively treated.
It is known that the fight against colds is more effective against the background of an increased temperature. It is also known that viscous substances, including phlegm, liquefy when heated.Therefore, traditional medicine recommends raising the temperature artificially and locally – using chemical (mustard plasters, balms) or thermal (banks, compresses) outside exposure. The problem is that in this way you can increase the temperature only in the skin, and even up to a burn. Do not warm up the lungs and bronchi from the outside.
It is much safer to take medications to dilute and remove sputum. For example, “Fluifort” *. It will allow you to avoid the accumulation of phlegm in the lungs, eliminate cough and ease the course of the disease.To find the exact dosage of the drug, consult your doctor.
Learn more about cough treatment
* Contraindications available. Before use, carefully read the instructions and consult a specialist.
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Honey should be treated for cough – new prescriptions of doctors
Photo author, Getty Images
Honey should be the first medical aid in the treatment of cough for most people, according to the new recommendations of doctors.
But antibiotics for the treatment of cough should be rarely used, since in most cases they do little to get rid of the problem, doctors say.
Most often, the cough goes away on its own within two to three weeks.
New guidelines for physicians should help address the problem of antibiotic resistance.
Overuse of antibiotics makes infections more difficult to treat as drug-resistant “super microbes” arise.
Hot drink with honey, lemon and ginger is a well-known home remedy for cough and sore throat.
Recently proposed guidelines from the Public Health England (PHE) and the National Institute for Health and Care Excellence (NICE) suggest there is some evidence that such a drink can help relieve cough symptoms.
Cough medicines containing pelargonium, guaifenesin or dextromethorphan may also be effective, they say.
Before going to the doctor, patients are advised to carry out such treatment and wait for the symptoms to ease on their own.
Most often, coughing is caused by viruses that do not respond to antibiotic treatment and are rendered harmless by themselves.
Despite this, the study has already found that 48% of British medical practices prescribe antibiotics for cough or bronchitis.
“Antibiotic resistance is a huge problem and we must now take action to reduce antibiotic use. These new guidelines will help doctors prescribe less antibiotics, and we urge patients to take their doctors’ advice on caring for their health.” Susan Hopkins, Deputy Director of PHE.
Photo Credit, Getty Images
However, prescriptions indicate that antibiotics may be needed to treat coughs if they are part of a more serious illness or when a person is at risk of further complications such as chronic illness or a weakened immune system …
Honey is also not recommended for children under one year old, as it sometimes contains bacteria that can cause infant botulism.
Dr. Tessa Lewis advises people to check their symptoms on the National Health Service website or consult a pharmacist.
“If the cough gets worse, not better, if the person is feeling very bad or choking, he needs to see a doctor,” she explains.
The draft guidelines are part of a series of new antibiotic prescriptions being developed jointly by PHE and NICE.
England’s chief physician, Professor Sally Davis, has previously warned of a “post-antibiotic apocalypse.”
If drugs don’t work, infections become difficult to treat, then medical procedures like cancer treatments and transplants are too risky, she explains.
Consultations on new recommendations will last until September 20.
Causes of a child’s cough
Cough itself cannot be considered a diagnosis. This is a symptom, a reflex reaction of the body to any problems in the respiratory tract, from an accidentally flown speck to serious diseases. The main task of the doctor is to figure out what went wrong and find the right approach that will eliminate the root cause of the child’s cough.
ARI and ARVI
The most common cause of cough in children is acute respiratory tract infections.Catching a virus, especially at school or in the garden, costs nothing, especially if a flu epidemic broke out in the city. It is difficult to predict what type of cough a child will receive, complete with snot and fever: the flu virus mutates every season. If you are lucky, it will be easy to cough up your throat, and the cough itself will gradually subside as the body develops antibodies, that is, by about the third day of illness. But you should not rely on luck when it comes to the health of the child, and you need to start cough treatment from the first days of the onset of a symptom, in order to prevent complications from occurring.Dr. IOM ® syrup can be taken from the first days of illness to relieve inflammation of the lungs of sputum excretion. Such a cough and special treatment will not be required, in addition to the general regimen. Drink as much as possible, moisturize and not overheat the air, rinse the nose and throat with saline, by agreement with the doctor (after five years) do inhalation or (from three years) rub the wings of the nose with ointment Doctor MOM ® Phyto with four essential oils. Now, if it is difficult for a child to cough up, that is, the cough is dry, you will have to make much more effort: the main task is to make the sputum liquid so that it leaves the bronchi, and does not stagnate there, drying up and creating all the conditions for bronchitis and pneumonia.Here, in addition to the constant humidifier and plentiful drink, the faithful assistant is the herbal syrup Doctor IOM ® with ten medicinal herbs.
Bronchitis worries parents much more than, say, ARVI – and this is completely true. But it must be borne in mind that when faced with another case of bronchitis, the doctor must each time determine the specific nature of the disease – after all, treatment depends on this. The most common causative agents of bronchitis are viruses.It so happens that viruses literally “open the way” for bacteria, and in this case, bronchitis, which began as a viral, can quickly become viral-bacterial. In viral bronchitis, antibiotics are not required, but in bacterial bronchitis, these drugs are the basis of therapy. Distinctive features of viral bronchitis are transparent or yellowish sputum, the child, of course, looks sick, but does not lie without strength and does not refuse his favorite food, and quite fast ” self-healing. ”With bacterial bronchitis, the sputum can be purulent, a weak, pale and lethargic baby can lie flat and refuse food.Without treatment, this condition lasts for a long time. If, on the 3-4th day of illness, fever and poor health persist, and the cough remains severe and hacking, most doctors recommend starting antibiotics. The basis for treating bronchitis is the correct regimen and plenty of drink. Antibiotics are prescribed strictly individually, you do not need to apply them yourself, focusing on previous experience or advice from friends. Distracting massage and gymnastics are used only if they do not cause discomfort to the little patient.Also pay attention to the herbal cough syrup Dr. IOM ® , it has a triple action, while simultaneously relieving inflammation, cleansing the bronchi and expelling phlegm.
Tracheitis can be especially difficult in childhood. Failure to provide timely treatment can provoke a chronic form of the disease, which will lead to a decrease in the immune system and frequent occurrence of viral respiratory diseases. That is why it is necessary to seek medical help at the first symptoms.The main symptom of tracheitis is cough, which is especially painful, dry and dull. Cough with tracheitis is not accompanied by sputum production, but if this happens, the sputum has a viscous consistency and there is not much of it. The cough causes pain in the chest area. The pain persists for a while and after coughing. Cough most often occurs at night, with long lying in one position. A harbinger of a cough is a sore throat, a slight coughing, which develops into a strong cough.Cough with tracheitis is often accompanied by fever and headaches. The child feels tired, becomes lethargic and apathetic. Often, children may experience a deterioration in mood. The main goal in the fight against tracheitis is to eliminate the inflammatory process, which is accompanied by a cough. Along with this, it is necessary to restore the child’s immune system and increase the content of vitamins in the body. When choosing a therapy together with a doctor, do not forget about the need for dilution and easy excretion of sputum.Syrup Doctor IOM ® based on 10 medicinal herbs will relieve inflammation and facilitate the excretion of phlegm.
Extremely contagious bacterial infection, known primarily for attacks of spasmodic cough. In children under one year old, they proceed so hard, up to respiratory arrest, that many parents prefer to pre-protect their children with a vaccine. a course of antibiotics.With this diagnosis, one has to resort to drugs that suppress the cough center in the brain, otherwise it is impossible to fight seizures. However, they can be mitigated if the patient is sent daily for many hours of walks, especially when it is not in the summer. for many years, a relapse will occur, it will be impossible to distinguish it from a common cold.Of the other common infections, cough occurs with measles, if it has not been vaccinated against it.
Quite often, a cough begins due to an allergy – to animal hair, pollen or simple house dust. You can understand what is going on only by donating blood and allergy tests, but it is not so difficult to remove acute symptoms: the main thing is to stay away from the source of irritation, rinse your nose and throat with saline and wipe all surfaces at least once, or even twice a day in the apartment with a damp cloth.
And dozens more options
In fact, a cough can indicate a variety of problems. Depending on many factors, with the same disease, different people may experience completely different symptoms. Therefore, examination and diagnosis should be carried out by a qualified doctor who will make a conclusion about the state of health based on the results of the study.
Pertussis: prevention and treatment
According to the WHO, 500-600 thousand children die from whooping cough in the world every year
Pertussis is a bacterial disease, it is transmitted from person to person, but in the external environment, whooping cough microbes, Borde-Jongu bacteria, not resistant, therefore, the disease is transmitted only through close contact by airborne droplets: in order to become infected, you need to play or communicate with the patient.You can’t catch whooping cough just by walking down the street past the source of the infection. The source of infection is only the patient. When coughing, sneezing, screaming, talking, saliva spray containing an infectious principle gets on the mucous membrane of healthy people and infects them. The most dangerous thing is that bacteria are released about a week before the onset of clinical manifestations. A person remains infectious for about two to three weeks during the illness. Whooping cough is especially dangerous for children under two years of age.
Conclusion 1: it is necessary to carefully monitor who the small child is playing with or is in the same room, and not to allow communication with coughing children.
How the disease develops
Borde Jongu bacteria enter the body through the upper respiratory tract. There they settle in the walls of the bronchi. Small bronchi and bronchioles are more severely affected: there are foci of necrosis (death). Irritation from receptors in the airways is transmitted to the cough center in the brain. Toxins released into the bloodstream by whooping cough microbes also irritate the cough center in the medulla oblongata. A focus of dominant excitement is gradually formed (as in epilepsy). The immune system fights bacteria and after a short time they no longer remain in the body, but the cough center (focus) remains agitated and the whooping cough clinic continues.
Conclusion 2: whooping cough can be treated with antibiotics, but only at an early stage. By the time the diagnosis is usually made, that is, in the second week of the convulsive period, it is no longer the means of choice.
Clinical manifestations of whooping cough
As people in Asia say, whooping cough is a 100-day cough, because whooping cough has a long course, that is, it is a very long cough.
The disease is divided into several periods:
- catarrhal period;
- spasmodic period;
The duration of each period is different, depending on the age of the patient and the severity of whooping cough.
Pertussis incubation period: can last from 4 days to two weeks, more often about a week. This is the time when there are still no clinical manifestations, but the child is already sick and even contagious.
Catarrhal period: the disease begins with mild catarrhal symptoms, this is just the moment when bacteria multiply in the wall of the respiratory tract. But the manifestations are insignificant: a slight runny nose, a slight cough without phlegm, and parents usually do not worry: they treat a runny nose and give expectorants.But a cough, which is dry from the very beginning, does not soften, phlegm does not appear.
Conclusion 3: if there is reason to suspect that a child has been infected with whooping cough (close contact with a sick person, an epidemic in the kindergarten group), you can take the culture during the incubation period, diagnose whooping cough and take antibiotics when Borde-Jongu bacteria are still in the body. This will be effective, the severity of the disease will be significantly reduced.
Spasmodic period of whooping cough: cough coughs in one attack become more and more, the child does not even have time to breathe.Most of all, the picture of each attack resembles a cough when a person choked on something. Each cough push is a short exhalation. It seems that there is no more air in the lungs, and the vocal cords are closed, the cough continues. Finally it is possible to inhale, but with a whistle or wheeze, this is called a reprise. A dry, prolonged cough in combination with reprisals is a classic clinical picture of the convulsive period of whooping cough. After inhalation, the cough continues, sometimes in one attack there are up to 3-4 reprises.In severe cases, the attack can last up to 4 minutes. The pressure in the veins of the head and on the face rises, the face of the sick child turns red, sometimes even pinpoint hemorrhages occur in the capillaries of the skin and eyes. When a sick child coughs, his tongue sticks out strongly, tears flow from his eyes. The attack either stops gradually or is resolved by vomiting. During coughing, the frenum of the tongue is sometimes injured. There can be only a few such attacks a day with a mild course, and there can be up to several dozen with a severe disease with whooping cough.With mild to moderate whooping cough, the general condition of children between attacks does not change: they feel good, play. In severe cases, patients are depressed, they are very tired during coughing, do not sleep well at night, show anxiety and are afraid of seizures. Since whooping cough cough occurs due to the activation of the cough center, irritation of other centers of the brain can provoke an attack, and hobby for something relieves the dominant irritation and reduces the likelihood of a coughing attack.
Conclusion 4: keep the child busy.Any strong and positive emotional stress can contribute to a quick recovery
Period of resolution . Gradually, the frequency of attacks decreases, the attacks themselves are shortened. “Whooping cough” is gradually replaced by an ordinary cough, which continues for about two weeks. Since the cough center is irritated, the resumption of the characteristic cough is possible with any cold. This is not the return of whooping cough, but the reaction of a recovered but not recovered organism to a new stimulus.
Whooping cough in babies
Whooping cough in babies under one year old is a serious threat to a baby’s life. A fulminant form of infection is noted, in which the incubation period may be absent, and the catarrhal period is reduced to several hours. Increasing spasms of the respiratory tract develop rapidly. Cardiovascular pathology joins. On the background of convulsive syndrome, clinical death can occur. An emergency placement of the baby in a specialized hospital is required.Very often, whooping cough in infants occurs in the so-called masked form. There are no pronounced reprises with coughing fits. Instead, there is a sudden cessation of breathing after a prolonged attack of screaming and hysteria after several cough shocks. There is a violation of the blood supply to the brain structures and heart muscle. A convulsive syndrome occurs, the baby’s face turns blue.
Conclusion 5: Whooping cough is especially dangerous for children under one year old. Infants often do not develop a complete clinical picture.Coughing attacks in babies are shorter, there are no reprises, but during an attack, respiratory arrest may occur.
What to do: if there is a cessation of breathing in an infant against the background of whooping cough, it is necessary to urgently induce vomiting. To do this, you need to put pressure on the root of the tongue. Activation of the vomiting center can restore breathing. It is worth opening the window, taking the child out into the street. In the absence of the effect of these measures, artificial respiration should be given. Urgent hospitalization is required. Consequences and complications: In children of the first year of life, whooping cough is dangerous due to respiratory arrest during attacks, the duration of which varies from several seconds to several minutes.Due to a lack of oxygen, they may develop skeletal muscle cramps, encephalopathy. Other complications of whooping cough are bronchitis, pleurisy, purulent otitis media, pseudo-croup. Occasionally, severe complications occur due to strong cough shocks (cerebral hemorrhage, ruptured eardrums, pneumothorax). Against the background of a weakened immune system and a decrease in the intensity of lymph movement in the lung tissue, stagnation begins. The most common complication of whooping cough is pneumonia with the addition of staphylococcal, streptococcal, pneumococcal, hemophilic and Pseudomonas aeruginosa pathogenic microflora.The disease in severe form can lead to prolonged hypoxia, which manifests itself in a violation of the blood supply to the brain and myocardium. This can provoke severe consequences of whooping cough in the form of structural changes, including enlargement of the ventricles and atria of the heart, and impaired brain activity.
Conclusion 6: after pertussis, ask the doctor what infections you need to vaccinate the child against in order to avoid further complications (against hemophilic infection, pneumococcal and influenza)
Diagnostics: The primary diagnosis is established based on the clinical picture, general analysis blood.Then, to clarify the diagnosis, a bacteriological culture of sputum or a throat swab is performed. For a faster establishment of the final diagnosis, a serological blood test may be performed for the presence of specific antibodies.
Treatment of pertussis in children: what to do and what to know?
- Remember about other people – about those who were in contact with your child, and those who may be in this contact – isolate the child, inform friends that visits are undesirable.
- Killing a microbe – the choice of an antibiotic (there are dozens of possible options), as well as the dose of the medicine, is a doctor’s business. The task of the parents is to achieve the ingestion of the drug inside the patient, to comply with the prescribed doses, frequency and timing of administration. (It is not difficult to kill whooping cough, although not all antibiotics work on it. But in the period of spasmodic cough, no effect – in the form of a decrease in the frequency and duration of attacks – can be noticed. And we already understand why – after all, the cough is not due to a microbe, but from for damage to the cells of the cough center.The main goal of taking antibiotics in this period is to make the patient not contagious)
- Refers to the disease philosophically and be aware that whooping cough is controllable only at the stage of prevention. But if you get sick, time turns out to be one of the main factors on the way to recovery. In short, until he coughs up his own – you shouldn’t really hope for any pills. (Since cough is of central origin, that is, it does not arise from inflammation in the airways, but because of irritation of the center of the cough in the brain, expectorant drugs are not indicated.Cough stimulants are contraindicated: mustard plasters and cans)
- You should know that coughing attacks can provoke: physical activity, sneezing, chewing, swallowing, negative emotions. The conclusions from this knowledge are quite logical: do not arrange active games with running, jumping and skating; avoid dust in every possible way, remove the child from the room during cleaning; try to ensure that the food offered to the child does not require special chewing and, at least for the duration of the illness, forget about chewing gum.(Considering the previous point, feeding a child with whooping cough is a particular problem. For some children, the very process of eating food becomes so scary that even the mention of food (for example, the phrase uttered by the mother: “let’s go eat”) causes a coughing fit. Fortunately, this happens rarely, but coughing after eating and vomiting everything that has been eaten is a fairly common phenomenon. You should not give a lot of food at once – even if you want to eat a lot. The longer you chew and the more you eat, the more likely you will have an attack and vomiting.Therefore, it is better to feed more often, but little by little. In principle, a cough with vomiting after it rarely happens 2 times in a row – i.e. if after an attack there was vomiting, then the next 2 3 attacks will be easier)
- One of the most important factors in the treatment of whooping cough is the correct answer to the question “how to breathe?” The drier the air and the warmer the room where the child is, the thicker the sputum, the greater the likelihood of both an increase in the frequency of attacks and the development of complications. But after all, the traditional actions when a child develops a cough is to keep him at home.And it is not surprising that after a month of coughing locked up, without walks and fresh air, supposedly “bronchitis” which, in fact, was mild whooping cough, ends with pneumonia. Therefore, it is necessary to remember and understand that fresh air is a prerequisite for proper care for a child not only with whooping cough, but also with other diseases accompanied by cough and bronchitis, and tracheitis, and with allergic lesions of the respiratory tract, and pneumonia. But, since the “other diseases” mentioned by us pass incomparably faster than whooping cough, then the negative consequences of a home regimen do not appear so often.Thus, if whooping cough has already been diagnosed, then all relatives of the patient should be mobilized in order to take turns with the child for a walk. In the summer, of course, it is not advisable to be where it is dry and warm, you need to get up early, while it is wet and cool, and it is imperative to take a longer walk before going to bed. It is only important not to forget that during the festivities one should avoid communicating with other children. It is very good to walk near water bodies, if there are any nearby. And if they are not, then it would not be bad at all to go to where they are – to the village to their grandmother, to the dacha, etc.p.
- Any cold, any acute respiratory disease in a child with whooping cough multiplies the manifestations of whooping cough itself and multiplies the risk of complications – all the same pneumonia. Prevention measures are quite standard – to minimize communication with other people, even if the child is no longer contagious, to prevent hypothermia, to isolate adults who have caught a cold.
- In principle, one should never forget about the possibility of developing pneumonia, and the thought that it has begun should appear when: – an increase in body temperature in the second or third week of the illness, especially when the temperature has increased, and a runny nose does not appear; – a sudden increase in the frequency of coughing and an increase in the duration of the attacks after it got better for several days, or at least did not get worse; – changes in general health – weakness, rapid breathing – in the intervals between attacks.It goes without saying that the diagnosis of pneumonia will be made by a doctor if it is called, but whooping cough lasts several months, and is treated, most often, at home. It often happens that it is not very convenient for parents to bother the doctor often, especially when the diagnosis is quite clear, and it is equally clear that recovery takes time and not a little. The ones listed above will help parents seek help in a timely manner.
- In the overwhelming majority of cases, whooping cough is treated (or goes away on its own) at home.But sometimes you can’t do without a hospital. So when is it? a) – whooping cough in children of the first year of life and especially (!) in the first half of the year – the risk of complications is very high, and the disease at this age is almost always very difficult; b) – regardless of age, when complications develop or when respiratory arrest appears against the background of a cough. It is quite logical to note the following: no one will ever keep a baby in the hospital until he is fully recovered. But both the hospital doctor and the child’s parents, before saying goodbye to each other, must be sure that the disease has passed its peak (there are no respiratory stops, complications have passed, within a few days the number of coughing attacks began to decrease).Antibiotics and fresh air treatment for whooping cough is, of course, not limited. Although from the huge arsenal of drugs that help with coughs, there is none that can significantly alleviate the course of the disease. The choice of a specific medicine is a matter for the doctor, but parents should know the following: even if, from your point of view, the prescribed medicine, for example, bromhexine, does not help at all, this does not at all mean that it is inexpedient to take it. The fact is that the mechanism of action of most expectorants (and the bromhexine mentioned by us as well) is based on the dilution of sputum.The child will not cough less often, but the likelihood of complications will decrease several times, since it is thick mucus, disrupting the patency of the bronchi, and is the main cause of the development of pneumonia
the number of refusals to vaccinate against this infection. This vaccination is included in the national vaccination calendar for children. However, many parents consider this event inappropriate and dangerous.For the sake of truth, it should be noted that, of the three components of this vaccine, pertussis is the most difficult to tolerate – i.e. it is with him that all those unpleasant sensations that the child experiences after vaccination are most often associated (malaise, fever, loss of appetite). In view of these fabrications, there is a deliberate refusal to vaccinate DPT …. According to the national vaccination calendar, pertussis vaccination is carried out three times in 3; 4.5 and 6 months, with a single revaccination at the age of 18 months.Vaccination protects against this disease at an early age, when it is most dangerous. In Russia, along with the domestic vaccine DPT (associated pertussis-diphtheria-tetanus toxoid), foreign analogues have been registered – acellular vaccines Pentaxim, Tetrakok, Infanrix and Infanrix Hexa. The local doctor will help you decide which vaccine you need to vaccinate your child.
Conclusion 7: Do not refuse to vaccinate your children. It is vaccination that is the only reliable way to prevent whooping cough! Of course, vaccinated children at an older age can get whooping cough, but the disease is incomparably easier.So much so that whooping cough is diagnosed dozens of times less often than this disease actually occurs and proceeds like a banal lung acute respiratory infection without complications.
Antibiotics for children
Antibiotics are, of course, a panacea. But is it worth it to immediately give them to the child when the child begins to fall ill ?! Of course not.
There are viruses, there are bacteria.Most of all children’s colds, fever and ailments are caused by viruses – an acute respiratory viral infection. Viruses cannot be treated with antibiotics; antibiotics only act on bacteria.
Whether or not to give antibiotics to a baby is a question that worries all mothers, and therefore they can be conditionally divided into 2 groups (according to their attitude towards antibacterial drugs):
The first group blindly supports the misconception that any childhood illness can be cured without antibiotics.These drugs act as a kind of monster for them, which devours the immune system and the baby’s gastrointestinal tract. Very often, such young ladies, hearing the word “antibiotic”, begin to be horrified and surprised: “How is that? What for? You don’t need it! ”. After that, get ready to listen to a lecture about the dangers of antibiotics for children and a stream of advice on how to treat toddlers without resorting to these drugs.
The second group of mothers are ardent adherents of antibiotic therapy, who are ready to treat a banal rhinitis with strong antibiotics.They argue their position by the fact that only these drugs help their children to recover quickly.
We would like to draw your attention to the fact that the above positions are fundamentally erroneous and you should not go to such extremes. Everywhere you need to adhere to common sense.
Antibiotic treatment is indicated only with proven bacterial infection and has its own prescription rules. When the baby’s temperature rises, a doctor’s examination is necessary for the cause of the high temperature.If the cause is viral changes in the pharynx, respiratory tract, then antibacterial treatment, as a rule, is not required, even if the child has a high fever. And then the cooperation of the mother and the doctor is necessary for the dynamic monitoring of the course of the disease. After 3-4 days with ARVI, the fever recedes, and antibiotics are not required.
The effect of antibiotics on the child’s body is very multifaceted, but there are situations when it is impossible to do without these drugs. Only a doctor should prescribe antibiotics.Do not self-medicate! Due to the unjustified use of these drugs, bacterial resistance to antibiotics appears, which in the future significantly complicates the treatment of the diseases caused by them.
By strictly observing the rules for taking antibiotics, it is possible to cope with the disease in a short time, while the damage to health in general will be minimal. On the contrary, uncontrolled intake of drugs is dangerous, therefore it is especially important to have an idea of the benefits and harms of antibacterial substances.For “lovers of antibiotic therapy” it is necessary to emphasize once again that antibiotics do not affect viruses and do not contribute to a decrease in body temperature, therefore, it is absolutely not worthwhile to self-medicate and take them “to prevent possible complications”.
The article was written by the pediatrician Savich Tatyana Anatolyevna. You can make an appointment with the leading specialists of the Dixion clinic by calling ☎ 76-00-00, 47-00-00.
Are antibiotics always the right solution? – Baltic Medical Center
Fever, runny nose, cough, general weakness… What will help if the disease starts to progress more rapidly? Most of us still think that when we get sick, antibiotics are most likely to help. But is it? Are antibiotics a cure for all diseases? When should you use them? Let’s talk about this with Inna Akhmetova, a doctor at the Baltic Medical Center.
1. What are antibiotics?
Antibiotics are medicines that act against bacteria that have entered the body.Bacterial infections are caused by various bacteria, therefore, there are different antibiotics. Different antibiotics act differently on microbes. Some destroy microbes, while others stop their growth and reproduction.
2. When should you use them?
Antibiotics are not a cure for all diseases, although many people mistakenly think otherwise.
Antibiotics are not recommended for the treatment of colds and viral diseases, since they do not affect viruses.
Ideally, antibiotics are given after the pathogen has been identified and is susceptible to antibiotics.
To determine the causative agent of the disease, material is taken from the source of inflammation for inoculation and antibiogram. But you need to wait for the answer within 3-4 days. Therefore, most often antibiotics are prescribed with the assumption of a possible pathogen and its sensitivity.
3. Why can only a doctor prescribe antibiotics?
There are many reasons why only a doctor can prescribe antibiotics.
Since an antibiotic only destroys bacteria, it is necessary to know the exact cause of the disease before prescribing them. Antibiotics do not fight infections caused by viruses, such as colds, flu, sore throat, bronchitis, and many ear infections. Therefore, antibiotics are not always suitable for treatment.
Only a doctor can properly assess the characteristics of the patient and the disease, changes in the state of health and decide which medicine to prescribe and how long to take it.Different antibiotics have different effects on the body. Some are more effective in the intestines, others in the bones, and others in other organs. Therefore, it is not recommended to take antibiotics without a doctor’s prescription.
4. Is it true that the use of antibiotics unnecessarily not only does not help, but can even harm health?
The use of antibiotics unnecessarily can cause allergic reactions, changes in the intestinal microflora, abdominal pain and diarrhea.When using antibiotics that are ineffective against pathogens, bacterial resistance, in other words, antibiotic resistance, can develop.
5. What rules should be followed when using antibiotics?
Antibiotics should be used only in the prescribed doses and for the prescribed time. If the dose is lower than the prescribed dose, antibiotic resistance can also develop. If, when using the prescribed dose, adverse reactions appear, you must inform your doctor about this.In no case should you reduce the dose yourself or interrupt the treatment. Stopping treatment prematurely can re-cause the infection because not all pathogens have been eradicated. It is important to know that an incomplete course of antibiotic treatment and a reduced dose of antibiotics on your own will stimulate the emergence of drug resistance in bacteria.
6. Is it always necessary to immediately consult a doctor when the first symptoms of the disease appear?
Often people rush to see a doctor unnecessarily when the first symptoms of a cold appear.When a cold appears, the main signs of which are sneezing, runny nose, sore throat, you can heal yourself within 2-3 days. Only if the temperature rises above 39 degrees, other symptoms appear – rash, vomiting, etc., in this case, you just need to see a doctor. It is necessary to immediately consult a doctor if a child is sick under the age of 2 years, as well as in case of a strong manifestation of symptoms of the disease.
7. How to distinguish
Only an objective examination will help to establish the true causative agent of the disease – a cold, a virus or an infection.Most often, a cold manifests itself in the form of a runny nose, sneezing, headache and sore throat. Even with a cold, the temperature can rise to 38 degrees and higher. The disease caused by the virus is characterized by severe weakness, fever, severe muscle pain, severe headache, and eye pain. A viral disease is characterized by an abrupt onset, dry cough.
8. How to treat viral infections?
Symptomatic treatment is recommended for viral infections.