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Patient information: Acute bronchitis in adults (Beyond the Basics) Author Thomas M File, Jr, MD Section Editor Daniel J Sexton, MD Deputy Editor Fenny H Lin, MD Find Print BRONCHITIS OVERVIEW Bronchitis develops when there is swelling and irritation of the bronchi, the large tubes that carry air to the lungs ( figure 1 ). There are two types of bronchitis: acute (sudden onset) and chronic (long-standing). Acute bronchitis often occurs with a viral infection, such as the common cold, and is sometimes called a "chest cold”. The most common symptom of acute bronchitis is a nagging cough. Treatment of acute bronchitis usually involves treating the symptoms, such as sore throat and congestion. Antibiotics do not help to eliminate acute bronchitis caused by a virus. Antiviral agents are useful in some cases of acute bronchitis due to influenza, but there are no antiviral agents for other forms of viral bronchitis. This article will review the causes, symptoms, diagnosis, and treatment of acute bronchitis. Articles that discuss the common cold and sore throat are also available. (See "Patient information: The common cold in adults (Beyond the Basics)" and "Patient information: Sore throat in adults (Beyond the Basics)" .) Chronic bronchitis is discussed separately. (See "Patient information: Chronic obstructive pulmonary disease (COPD), including emphysema (Beyond the Basics)" .) More detailed information about acute bronchitis is available by subscription. (See "Acute bronchitis in adults" .) BRONCHITIS CAUSES Most cases of bronchitis are caused by a viral infection of the upper airways, such as the common cold or the flu. Less commonly, a bacterium called Bordetella pertussis, which causes pertussis (whooping cough), is the cause. (See 'Whooping cough' below.) BRONCHITIS SYMPTOMS The most common symptoms of acute bronchitis include: A persistent cough; this may last 10 to 20 days Some people cough up mucus, which may be clear, yellow, or green in color Fever is not common in people with acute bronchitis. However, having a fever can be a sign of another condition, such as the flu or pneumonia. (See "Patient information: Influenza symptoms and treatment (Beyond the Basics)" and "Patient information: Pneumonia in adults (Beyond the Basics)" .) Conditions with similar features  — There are other conditions that have symptoms similar to those of acute bronchitis.

Fever is not common in people with acute bronchitis. However, having a fever can be a sign of another condition, such as the flu or pneumonia. (See "Patient information: Influenza symptoms and treatment (Beyond the Basics)" and "Patient information: Pneumonia in adults (Beyond the Basics)" .) Conditions with similar features  — There are other conditions that have symptoms similar to those of acute bronchitis. Chronic cough — A persistent cough that lasts more than eight weeks is considered a chronic cough, which is discussed in detail elsewhere. (See "Patient information: Chronic cough in adults (Beyond the Basics)" .) Chronic bronchitis — Chronic bronchitis is defined as a cough that occurs on most days of the month for at least three months of the year during two consecutive years. This condition is discussed separately. (See "Patient information: Chronic obstructive pulmonary disease (COPD), including emphysema (Beyond the Basics)" .) Pneumonia — Signs of pneumonia include fever and a fast heart and breathing rate. (See "Patient information: Pneumonia in adults (Beyond the Basics)" .) Postnasal drip — Postnasal drip occurs when secretions drain from the sinuses into the throat. This can cause the throat to feel irritated, which causes you to feel like you need to clear your throat frequently. Postnasal drip can be caused by the common cold, allergies, sinusitis, or environmental irritants. (See "Patient information: Allergic rhinitis (seasonal allergies) (Beyond the Basics)" .) BRONCHITIS DIAGNOSIS Most people who have a persistent cough after an upper respiratory infection (cold) do not need to see a healthcare provider. Diagnostic testing, such as x-rays, cultures, and blood tests, are not usually needed for people with acute bronchitis. However, testing may be recommended if your diagnosis is not clear based upon your examination or if another condition, such as pneumonia, is suspected. When to seek help  — You should call your healthcare provider if you have any of the following: Fever (temperature greater than 100.4º F or 38º C) A cough that lasts longer than 10 days Chest pain with coughing, difficulty breathing, or coughing up blood A barking cough that makes it hard to speak, especially if it persists Cough accompanied by unexplained weight loss

When to seek help  — You should call your healthcare provider if you have any of the following: Fever (temperature greater than 100.4º F or 38º C) A cough that lasts longer than 10 days Chest pain with coughing, difficulty breathing, or coughing up blood A barking cough that makes it hard to speak, especially if it persists Cough accompanied by unexplained weight loss People who are older than 75 do not always have a fever or other concerning symptoms. If you are over 75 years and you have a persistent cough, you should call your clinician to determine if and when an office visit is recommended. BRONCHITIS TREATMENT Relief of symptoms  — There is no specific treatment for bronchitis. There are a few treatments available for the common cold. (See "Patient information: The common cold in adults (Beyond the Basics)" .) A nonsteroidal antiinflammatory drug (ibuprofen, naproxen), aspirin, or acetaminophen (Tylenol®) can help to relieve the pain of a sore throat or headache. Heated, humidified, air can improve symptoms of nasal congestion and runny nose, and has few to no side effects. Cough suppressant medications have not been shown to be helpful for most patients. Inhaler medications, commonly used for patients with asthma, are only helpful for those patients whose symptoms include wheezing or airflow obstruction and would require prescription. Antibiotics  — Antibiotics are NOT helpful for most people with bronchitis since the illness is typically caused by a virus. Antibiotics treat bacterial, not viral infections. Many people request antibiotics in the hopes that it will get rid of the cough, and some people even think that antibiotics have helped on previous occasions. However, there is no benefit of antibiotics for most cases of bronchitis. Whooping cough  — Whooping cough is caused by a bacterium, Bordetella pertussis. A vaccine is routinely given during childhood, and again during adolescence or adulthood, to reduce the risk of becoming infected with pertussis. However, the illness can still develop in those who were vaccinated. (See "Clinical manifestations and diagnosis of Bordetella pertussis infections in adolescents and adults" .)

Whooping cough  — Whooping cough is caused by a bacterium, Bordetella pertussis. A vaccine is routinely given during childhood, and again during adolescence or adulthood, to reduce the risk of becoming infected with pertussis. However, the illness can still develop in those who were vaccinated. (See "Clinical manifestations and diagnosis of Bordetella pertussis infections in adolescents and adults" .) Signs of whooping cough in adults include repeated "spasms" of severe coughing, sometimes followed by vomiting. Whooping cough often occurs as outbreaks, usually involving people who are incompletely immunized. If whooping cough is suspected, your healthcare provider may prescribe an antibiotic. Antibiotics will not help the cough, but can reduce the risk of spreading the infection to others. (See "Treatment and prevention of Bordetella pertussis infection in adolescents and adults" .) PREVENTING THE SPREAD OF ILLNESS Hand washing is an essential and highly effective way to prevent the spread of infection. Wet your hands with water and plain soap and rub them together for 15 to 30 seconds. Pay special attention to the fingernails, between the fingers, and the wrists. Rinse your hands thoroughly, and dry with a single use towel. Alcohol-based hand rubs are a good alternative for disinfecting hands if a sink is not available. Spread the hand rub over the entire surface of your hands, fingers, and wrists until dry. You can use hand rubs repeatedly without irritating the skin or losing effectiveness. Hand rubs are available as a liquid or wipe in small, portable sizes that are easy to carry in a pocket or handbag. When a sink is available, you should wash visibly soiled hands with soap and water. Wash your hands before preparing food and eating; after going to the bathroom; and after coughing, blowing the nose, or sneezing. While it is not always possible to limit contact with people who are ill, avoid touching your eyes, nose, or mouth after direct contact, when possible. In addition, use a tissue to cover your mouth when sneezing or coughing. Throw away used tissues promptly and then wash your hands. Sneezing/coughing into the sleeve of your clothing (at the inner elbow) is another way of containing sprays of saliva and secretions and does not contaminate your hands. Sneezing and coughing without covering your mouth can spread infection to anyone within six feet.

In addition, use a tissue to cover your mouth when sneezing or coughing. Throw away used tissues promptly and then wash your hands. Sneezing/coughing into the sleeve of your clothing (at the inner elbow) is another way of containing sprays of saliva and secretions and does not contaminate your hands. Sneezing and coughing without covering your mouth can spread infection to anyone within six feet. WHERE TO GET MORE INFORMATION Your healthcare provider is the best source of information for questions and concerns related to your medical problem. This article will be updated as needed on our web site ( www.uptodate.com/patients ). Related topics for patients, as well as selected articles written for healthcare professionals, are also available. Some of the most relevant are listed below. Patient level information  — UpToDate offers two types of patient education materials. The Basics  — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials. Patient information: Acute bronchitis (The Basics) Beyond the Basics  — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon. Patient information: The common cold in adults (Beyond the Basics) Patient information: Sore throat in adults (Beyond the Basics) Patient information: Chronic obstructive pulmonary disease (COPD), including emphysema (Beyond the Basics) Patient information: Influenza symptoms and treatment (Beyond the Basics) Patient information: Pneumonia in adults (Beyond the Basics) Patient information: Chronic cough in adults (Beyond the Basics) Patient information: Allergic rhinitis (seasonal allergies) (Beyond the Basics) Professional level information  — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

Professional level information  — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading. Acute bronchitis in adults Clinical manifestations and diagnosis of Bordetella pertussis infections in adolescents and adults Management of infection in acute exacerbations of chronic obstructive pulmonary disease Etiology and evaluation of hemoptysis in adults Fluoroquinolones Respiratory syncytial virus infection: Clinical features and diagnosis The common cold in adults: Treatment and prevention Treatment and prevention of Bordetella pertussis infection in adolescents and adults The following organizations also provide reliable health information. National Library of Medicine ( www.nlm.nih.gov/medlineplus/bronchitis.html ) Centers for Disease Control and Prevention (CDC) ( www.cdc.gov/getsmart/antibiotic-use/URI/bronchitis.html ) [ 1-3 ] Literature review current through: Oct 2013. | This topic last updated: Sep 9, 2011. Find Print The content on the UpToDate website is not intended nor recommended as a substitutefor medical advice, diagnosis, or treatment. Always seek the advice of your own physician orother qualified health care professional regarding any medical questions or conditions. Theuse of this website is governed by the UpToDate Terms of Use ©2013 UpToDate, Inc. References Top Snow V, Mottur-Pilson C, Gonzales R, et al. Principles of appropriate antibiotic use for treatment of acute bronchitis in adults. Ann Intern Med 2001; 134:518. Wenzel RP, Fowler AA 3rd. Clinical practice. Acute bronchitis. N Engl J Med 2006; 355:2125. Braman SS. Chronic cough due to acute bronchitis: ACCP evidence-based clinical practice guidelines. Chest 2006; 129:95S.

REFERENCES 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. Gonzales R, Steiner JF, Lum A, Barrett PH Jr. Decreasing antibiotic use in ambulatory practice: impact of a multidimensional intervention on the treatment of uncomplicated acute bronchitis in adults. JAMA 1999; 281:1512. Evertsen J, Baumgardner DJ, Regnery A, Banerjee I. Diagnosis and management of pneumonia and bronchitis in outpatient primary care practices. Prim Care Respir J 2010; 19:237. Kroening-Roche JC, Soroudi A, Castillo EM, Vilke GM. Antibiotic and bronchodilator prescribing for acute bronchitis in the emergency department. J Emerg Med 2012; 43:221. Schuetz P, Amin DN, Greenwald JL. Role of procalcitonin in managing adult patients with respiratory tract infections. Chest 2012; 141:1063. Snow V, Mottur-Pilson C, Gonzales R, et al. Principles of appropriate antibiotic use for treatment of acute bronchitis in adults. Ann Intern Med 2001; 134:518. Gonzales R, Bartlett JG, Besser RE, et al. Principles of appropriate antibiotic use for treatment of uncomplicated acute bronchitis: background. Ann Intern Med 2001; 134:521. Steinman MA, Gonzales R, Linder JA, Landefeld CS. Changing use of antibiotics in community-based outpatient practice, 1991-1999. Ann Intern Med 2003; 138:525. McCaig LF, Besser RE, Hughes JM. Antimicrobial drug prescription in ambulatory care settings, United States, 1992-2000. Emerg Infect Dis 2003; 9:432. Falsey AR, Erdman D, Anderson LJ, Walsh EE. Human metapneumovirus infections in young and elderly adults. J Infect Dis 2003; 187:785. Boldy DA, Skidmore SJ, Ayres JG. Acute bronchitis in the community: clinical features, infective factors, changes in pulmonary function and bronchial reactivity to histamine. Respir Med 1990; 84:377. Jonsson JS, Sigurdsson JA, Kristinsson KG, et al. Acute bronchitis in adults. How close do we come to its aetiology in general practice? Scand J Prim Health Care 1997; 15:156. MacKay DN. Treatment of acute bronchitis in adults without underlying lung disease. J Gen Intern Med 1996; 11:557. Denny FW, Clyde WA Jr, Glezen WP. Mycoplasma pneumoniae disease: clinical spectrum, pathophysiology, epidemiology, and control. J Infect Dis 1971; 123:74.

Jonsson JS, Sigurdsson JA, Kristinsson KG, et al. Acute bronchitis in adults. How close do we come to its aetiology in general practice? Scand J Prim Health Care 1997; 15:156. MacKay DN. Treatment of acute bronchitis in adults without underlying lung disease. J Gen Intern Med 1996; 11:557. Denny FW, Clyde WA Jr, Glezen WP. Mycoplasma pneumoniae disease: clinical spectrum, pathophysiology, epidemiology, and control. J Infect Dis 1971; 123:74. Wadowsky RM, Castilla EA, Laus S, et al. Evaluation of Chlamydia pneumoniae and Mycoplasma pneumoniae as etiologic agents of persistent cough in adolescents and adults. J Clin Microbiol 2002; 40:637. Foy HM, Kenny GE, Cooney MK, Allan ID. Long-term epidemiology of infections with Mycoplasma pneumoniae. J Infect Dis 1979; 139:681. Johnson S. Possibly autoantibody complications in Mycoplasma pneumoniae infection. Clin Infect Dis 2006; 43:1246. Powell DA, Hu PC, Wilson M, et al. Attachment of Mycoplasma pneumoniae to respiratory epithelium. Infect Immun 1976; 13:959. Grayston JT, Kuo CC, Wang SP, Altman J. A new Chlamydia psittaci strain, TWAR, isolated in acute respiratory tract infections. N Engl J Med 1986; 315:161. Grayston JT, Diwan VK, Cooney M, Wang SP. Community- and hospital-acquired pneumonia associated with Chlamydia TWAR infection demonstrated serologically. Arch Intern Med 1989; 149:169. Ward JI, Cherry JD, Chang SJ, et al. Efficacy of an acellular pertussis vaccine among adolescents and adults. N Engl J Med 2005; 353:1555. Cornia PB, Hersh AL, Lipsky BA, et al. Does this coughing adolescent or adult patient have pertussis? JAMA 2010; 304:890. Nennig ME, Shinefield HR, Edwards KM, et al. Prevalence and incidence of adult pertussis in an urban population. JAMA 1996; 275:1672. Wenzel RP, Fowler AA 3rd. Clinical practice. Acute bronchitis. N Engl J Med 2006; 355:2125. Dingle JH, Badger GF, Jordan WS Jr. Illness in the home: A study of 25,000 illnesses in a group of Cleveland families, The Press of Western Reserve University, Cleveland 1964. p.68. Williamson HA Jr. Pulmonary function tests in acute bronchitis: evidence for reversible airway obstruction. J Fam Pract 1987; 25:251. Müller B, Harbarth S, Stolz D, et al. Diagnostic and prognostic accuracy of clinical and laboratory parameters in community-acquired pneumonia. BMC Infect Dis 2007; 7:10.

Dingle JH, Badger GF, Jordan WS Jr. Illness in the home: A study of 25,000 illnesses in a group of Cleveland families, The Press of Western Reserve University, Cleveland 1964. p.68. Williamson HA Jr. Pulmonary function tests in acute bronchitis: evidence for reversible airway obstruction. J Fam Pract 1987; 25:251. Müller B, Harbarth S, Stolz D, et al. Diagnostic and prognostic accuracy of clinical and laboratory parameters in community-acquired pneumonia. BMC Infect Dis 2007; 7:10. Metlay JP, Schulz R, Li YH, et al. Influence of age on symptoms at presentation in patients with community-acquired pneumonia. Arch Intern Med 1997; 157:1453. Gonzales R, Sande M. What will it take to stop physicians from prescribing antibiotics in acute bronchitis? Lancet 1995; 345:665. Hoppe JE. Methods for isolation of Bordetella pertussis from patients with whooping cough. Eur J Clin Microbiol Infect Dis 1988; 7:616. Sotir MJ, Cappozzo DL, Warshauer DM, et al. Evaluation of polymerase chain reaction and culture for diagnosis of pertussis in the control of a county-wide outbreak focused among adolescents and adults. Clin Infect Dis 2007; 44:1216. Koidl C, Bozic M, Burmeister A, et al. Detection and differentiation of Bordetella spp. by real-time PCR. J Clin Microbiol 2007; 45:347. Faix DJ, Sherman SS, Waterman SH. Rapid-test sensitivity for novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med 2009; 361:728. Centers for Disease Control and Prevention (CDC). Evaluation of rapid influenza diagnostic tests for influenza A (H3N2)v virus and updated case count--United States, 2012. MMWR Morb Mortal Wkly Rep 2012; 61:619. Hurt AC, Alexander R, Hibbert J, et al. Performance of six influenza rapid tests in detecting human influenza in clinical specimens. J Clin Virol 2007; 39:132. Harper SA, Bradley JS, Englund JA, et al. Seasonal influenza in adults and children--diagnosis, treatment, chemoprophylaxis, and institutional outbreak management: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis 2009; 48:1003. Klausner JD, Passaro D, Rosenberg J, et al. Enhanced control of an outbreak of Mycoplasma pneumoniae pneumonia with azithromycin prophylaxis. J Infect Dis 1998; 177:161. Klement E, Talkington DF, Wasserzug O, et al. Identification of risk factors for infection in an outbreak of Mycoplasma pneumoniae respiratory tract disease. Clin Infect Dis 2006; 43:1239.

Klausner JD, Passaro D, Rosenberg J, et al. Enhanced control of an outbreak of Mycoplasma pneumoniae pneumonia with azithromycin prophylaxis. J Infect Dis 1998; 177:161. Klement E, Talkington DF, Wasserzug O, et al. Identification of risk factors for infection in an outbreak of Mycoplasma pneumoniae respiratory tract disease. Clin Infect Dis 2006; 43:1239. Uldum SA, Jensen JS, Søndergård-Andersen J, Lind K. Enzyme immunoassay for detection of immunoglobulin M (IgM) and IgG antibodies to Mycoplasma pneumoniae. J Clin Microbiol 1992; 30:1198. Shuvy M, Rav-Acha M, Izhar U, et al. Massive empyema caused by Mycoplasma pneumoniae in an adult: a case report. BMC Infect Dis 2006; 6:18. Biberfeld G, Biberfeld P, Wigzell H. Antibodies of surface antigens of lymphocytes and lymphoblastoid cells in cold-agglutinin-positive sera from patients with Mycoplasma pneumoniae infection. Scand J Immunol 1976; 5:87. Bartlett JG, Dowell SF, Mandell LA, et al. Practice guidelines for the management of community-acquired pneumonia in adults. Infectious Diseases Society of America. Clin Infect Dis 2000; 31:347. Kumar S, Hammerschlag MR. Acute respiratory infection due to Chlamydia pneumoniae: current status of diagnostic methods. Clin Infect Dis 2007; 44:568. Tuuminen T, Palomäki P, Paavonen J. The use of serologic tests for the diagnosis of chlamydial infections. J Microbiol Methods 2000; 42:265. Murdoch DR. Molecular genetic methods in the diagnosis of lower respiratory tract infections. APMIS 2004; 112:713. Schuetz P, Christ-Crain M, Thomann R, et al. Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial. JAMA 2009; 302:1059. Briel M, Schuetz P, Mueller B, et al. Procalcitonin-guided antibiotic use vs a standard approach for acute respiratory tract infections in primary care. Arch Intern Med 2008; 168:2000. Burkhardt O, Ewig S, Haagen U, et al. Procalcitonin guidance and reduction of antibiotic use in acute respiratory tract infection. Eur Respir J 2010; 36:601. Schuetz P, Chiappa V, Briel M, Greenwald JL. Procalcitonin algorithms for antibiotic therapy decisions: a systematic review of randomized controlled trials and recommendations for clinical algorithms. Arch Intern Med 2011; 171:1322.

Burkhardt O, Ewig S, Haagen U, et al. Procalcitonin guidance and reduction of antibiotic use in acute respiratory tract infection. Eur Respir J 2010; 36:601. Schuetz P, Chiappa V, Briel M, Greenwald JL. Procalcitonin algorithms for antibiotic therapy decisions: a systematic review of randomized controlled trials and recommendations for clinical algorithms. Arch Intern Med 2011; 171:1322. Schuetz P, Müller B, Christ-Crain M, et al. Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections. Cochrane Database Syst Rev 2012; 9:CD007498. Prieto B, Alvarez FV. Lack of transferability of results between procalcitonin assays. Clin Chem 2009; 55:2226. Gilbert DN. Procalcitonin as a biomarker in respiratory tract infection. Clin Infect Dis 2011; 52 Suppl 4:S346. Celli BR, MacNee W, ATS/ERS Task Force. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004; 23:932. Metlay JP, Kapoor WN, Fine MJ. Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination. JAMA 1997; 278:1440. Jónsson JS, Gíslason T, Gíslason D, Sigurdsson JA. Acute bronchitis and clinical outcome three years later: prospective cohort study. BMJ 1998; 317:1433. Hallett JS, Jacobs RL. Recurrent acute bronchitis: the association with undiagnosed bronchial asthma. Ann Allergy 1985; 55:568. Bolser DC. Cough suppressant and pharmacologic protussive therapy: ACCP evidence-based clinical practice guidelines. Chest 2006; 129:238S. Smucny JJ, Flynn CA, Becker LA, Glazier RH. Are beta2-agonists effective treatment for acute bronchitis or acute cough in patients without underlying pulmonary disease? A systematic review. J Fam Pract 2001; 50:945. Braman SS. Chronic cough due to acute bronchitis: ACCP evidence-based clinical practice guidelines. Chest 2006; 129:95S. Becker LA, Hom J, Villasis-Keever M, van der Wouden JC. Beta2-agonists for acute bronchitis. Cochrane Database Syst Rev 2011; :CD001726. Smith SM, Schroeder K, Fahey T. Over-the-counter (OTC) medications for acute cough in children and adults in ambulatory settings. Cochrane Database Syst Rev 2012; 8:CD001831. Jiang L, Li K, Wu T. Chinese medicinal herbs for acute bronchitis. Cochrane Database Syst Rev 2012; 2:CD004560.

Becker LA, Hom J, Villasis-Keever M, van der Wouden JC. Beta2-agonists for acute bronchitis. Cochrane Database Syst Rev 2011; :CD001726. Smith SM, Schroeder K, Fahey T. Over-the-counter (OTC) medications for acute cough in children and adults in ambulatory settings. Cochrane Database Syst Rev 2012; 8:CD001831. Jiang L, Li K, Wu T. Chinese medicinal herbs for acute bronchitis. Cochrane Database Syst Rev 2012; 2:CD004560. Little P, Rumsby K, Kelly J, et al. Information leaflet and antibiotic prescribing strategies for acute lower respiratory tract infection: a randomized controlled trial. JAMA 2005; 293:3029. Smith SM, Fahey T, Smucny J, et al. Antibiotics for acute bronchitis. Cochrane Database Syst Rev 2012; CD000245. Shehab N, Patel PR, Srinivasan A, Budnitz DS. Emergency department visits for antibiotic-associated adverse events. Clin Infect Dis 2008; 47:735. Little P, Stuart B, Moore M, et al. Amoxicillin for acute lower-respiratory-tract infection in primary care when pneumonia is not suspected: a 12-country, randomised, placebo-controlled trial. Lancet Infect Dis 2013; 13:123. 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. file://publications.nice.org.uk/respiratory-tract-infections-antibiotic-prescribing-cg69/guidance (Accessed on February 20, 2013). National Quality Forum (NQF). Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis. Available at: file://www.qualityforum.org/MeasureDetails.aspx?actid=0&SubmissionId=1216#p=5&s=n&so=a (Accessed on July 31, 2012). Roth S, Gonzales R, Harding-Anderer T, et al. Unintended consequences of a quality measure for acute bronchitis. Am J Manag Care 2012; 18:e217. Gonzales R, Anderer T, McCulloch CE, et al. A cluster randomized trial of decision support strategies for reducing antibiotic use in acute bronchitis. JAMA Intern Med 2013; 173:267. Linder JA. Antibiotic Prescribing for Acute Respiratory Infections-Success That's Way Off the Mark: Comment on "A Cluster Randomized Trial of Decision Support Strategies for Reducing Antibiotic Use in Acute Bronchitis". JAMA Intern Med 2013; 173:273.

Gonzales R, Anderer T, McCulloch CE, et al. A cluster randomized trial of decision support strategies for reducing antibiotic use in acute bronchitis. JAMA Intern Med 2013; 173:267. Linder JA. Antibiotic Prescribing for Acute Respiratory Infections-Success That's Way Off the Mark: Comment on "A Cluster Randomized Trial of Decision Support Strategies for Reducing Antibiotic Use in Acute Bronchitis". JAMA Intern Med 2013; 173:273. Bergquist SO, Bernander S, Dahnsjö H, Sundelöf B. Erythromycin in the treatment of pertussis: a study of bacteriologic and clinical effects. Pediatr Infect Dis J 1987; 6:458. Treanor JJ, Hayden FG, Vrooman PS, et al. Efficacy and safety of the oral neuraminidase inhibitor oseltamivir in treating acute influenza: a randomized controlled trial. US Oral Neuraminidase Study Group. JAMA 2000; 283:1016. Bradley JS, Englund JA, File TM, et al. Influenza H1N1: Frontline questions and expert opinion answers. Available at: www.idsociety.org/Content/aspx?id=15743 (Accessed on January 13, 2009). Topic 6870 Version 20.0 © 2013 UpToDate, Inc. All rights reserved. | Subscription and License Agreement | Release: 21.6- C21.56 Licensed to: AsanBook Dig. Med. Lib. | Support Tag: [1004-122.72.76.133-420B8D9EB9-S244013.14]