Harvard Women's Health Watch

What to do for bronchitis

Although this upper respiratory infection may last longer than the common cold, it usually doesn’t warrant antibiotics or medical treatment.

We all know the common cold very well; the average adult has several every year. “Chest colds,” or bronchitis episodes, are much less frequent, affecting only 5% of adults per year. Perhaps because bronchitis is accompanied by a persistent, nagging cough, we tend to think of it as a more serious illness. It is the fifth most common reason people see their primary care provider.

What is bronchitis?

Bronchitis is an inflammation of the bronchi—the tubes leading from the trachea, or windpipe, to the lungs. Bronchitis often begins as an infection in your nose, sinuses, ears, or throat, and moves into the bronchi.

A cough is the main symptom of bronchitis. It may be a dry cough, or you may cough up phlegm that may be yellowish or greenish—a sign that your body is fighting the infection. You may be unusually tired or have a sore throat, chest discomfort, wheezing, or shortness of breath. “Like a cold, bronchitis usually clears up on its own,” says Dr. Jeffrey Linder, a primary care doctor and researcher at Harvard-affiliated Brigham and Women’s Hospital. “The bad news is that it lasts longer—up to three weeks. Although you are likely to be feeling better within a week, your cough may last another two weeks.”

How to treat bronchitis

In general, treat bronchitis as you would a cold—with rest, lots of fluids, and acetaminophen for pain. Breathing steam from a vaporizer or a bowl of hot water or taking a hot shower can help to loosen phlegm. Over-the-counter cough suppressants can help you get through the days and sleep through the nights.

When to call the doctor

You may feel chilled or run a low fever with bronchitis. However, if you develop a persistent temperature above 100° F accompanied by shaking chills, or if you’re having difficulty breathing, you should call the doctor. A cough that produces thick mucus that is bloody or smells foul also warrants medical attention. These may be signs that you’ve developed pneumonia. Even if you don’t have pneumonia, your doctor may prescribe an inhaler containing a bronchodilator to open your airways or suggest a medication to suppress your cough so that you can sleep through the night.

If you continue to cough up phlegm for more than a month, you should check with your doctor. You may have chronic bronchitis—one of the components of chronic obstructive pulmonary disease—and need additional treatment.

Why antibiotics won’t help bronchitis

In an analysis published in The Journal of the American Medical Association in 2014, Dr. Jeffrey Linder and colleagues determined that 71% of patients who saw a physician for bronchitis were prescribed antibiotics. He explains that people often get antibiotics after they’ve been coughing for a week or two or because they are concerned about phlegm. Because the cough often clears up a few days later on its own, they wrongly assume that the antibiotic helped. In fact, about 95% of bronchitis cases are caused by viruses, and antibiotics, which are designed to kill bacteria, have no effect on viruses.

Not only are antibiotics unlikely to get rid of your infection, they may cause diarrhea and other side effects. Moreover, taking antibiotics unnecessarily helps foster the development of drug-resistant pathogens, or “superbugs.”

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