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Once you suspect that you may have acute bronchitis, your first thought may be that you need a course of antibiotics. You'd be wrong, and here's why.

Coughing. Shortness of breath. Wheezing. Perhaps a slight fever, and a feeling of tightness in the chest. These are the symptoms of acute bronchitis [1] — though other conditions can also manifest themselves in this way.

If you suspect that you have acute bronchitis, you might quickly conclude that anything with "-itis" at the end is commonly treated with antibiotics, and that you need to go grab yourself a course. The truth is much more complicated. 

Suspected Acute Bronchitis: Do You Need To See A Doctor?

Acute bronchitis isn't actually usually that serious. It tends to start as a virus (often one that also causes a common cold) in the throat or nose, after which it reaches the bronchial tubes, the lining of which becomes inflamed, manifesting in the symptoms you're struggling with. Acute bronchitis typically runs its course within three days to a week, and most people get all better without any medical intervention. 

Acute bronchitis can, in some cases, have more severe consequences, however. Elderly people, young children, and those with existing medical conditions, including respiratory diseases, are especially at risk of complications. In addition, acute bronchitis can be caused by bacteria and irritants as well as viruses. [1, 2]

Do you have acute bronchitis and do you need to see a doctor? If you're asking yourself these questions, the short answer is "ideally". You should always see a doctor if you are experiencing real breathing difficulties, and when you do so, keep in mind that your suspected self-diagnosis of acute bronchitis might be wrong. Also see a doctor if your symptoms are bearable, but don't go away within a week or so, and if you keep on having bouts of suspected bronchitis, in which case you may be dealing with chronic bronchitis

The good news is that you'd definitely need to see a doctor to get antibiotics, so this is one kind of medication you won't wrongly be "self-prescribing". If you do have acute bronchitis and nothing more, your medical checkup will nearly always result in your healthcare provider telling you that you really don't need antibiotics. 

Why Are Antibiotics Not Usually Given For Acute Bronchitis?

First off, acute bronchitis is often, as we've already seen, caused by viruses and irritants — causes antibiotics don't help with at all. The CDC notes that though bacteria can also be behind acute bronchitis, antibiotics aren't recommended in those cases either, as they will not speed the recovery process along. [3] (Though we should add that your doctor probably won't know what's behind your acute bronchitis, as a diagnosis tends to be made on the basis of symptoms and a physical examination, rather than lab tests.)

There is plenty of research to back this up. A review of studies on the topic of antibiotics and acute bronchitis noted that "some" people diagnosed with acute bronchitis reported faster recovery when given antibiotics. This "faster" amounted to half a day over the course of an illness that lasted eight to 10 days, however, so it was hardly significant. On the other hand, the review also found that people who received antibiotics had more side effects, such as nausea and vomiting, headaches, and skin rashes. The authors concluded that there is no benefit in offering antibiotics to otherwise healthy folks with acute bronchitis, but people who belong to at-risk groups may benefit, something that requires further study to ascertain. [4]

The authors of another study, acknowledging that excessive antibiotic prescription for acute respiratory infections is one of the main causes of the increase in antibiotic-resistant Streptococcus pneumoniae, noted that clinics prescribed antibiotics in up to 74 percent of uncomplicated cases of acute bronchitis. Hoping to reduce this practice, and thereby also the spread of antibiotic-resistant superbugs, they staged an intervention. By the end of the study, antibiotics were only prescribed in 48 percent of cases. The authors noted that decreased antibiotic prescription didn't lead to increased numbers of return visits for bronchitis or pneumonia, demonstrating that not prescribing antibiotics is the correct course of action. [5]

In conclusion, not only will antibiotics usually not help treat your acute bronchitis — by prescribing them, your doctor is contributing to a world in which people will once again succumb to infections we have been able to treat easily since the emergence of antibiotics in massive numbers. [6] The fight against antibiotic-resistant infections is on, and its result will have a tremendous impact on all of humanity. 

What Can You Do To Manage Acute Bronchitis, Then?

Your doctor will probably recommend that you rest up, use a cough suppressant and pain relief as needed, and eat healthily. In severe cases, a bronchodilator (inhaler) may be on the table. You will also certainly want to refrain from smoking and being around second-hand smoke or other chemical irritants. [7

Steam inhalation therapy may help with acute bronchitis as well, and you'll typically be told to drink plenty of fluids. What does proper hydration have to do with treating acute bronchitis? Though the theory that increased fluid intake leads to better phlegm expulsion has been debunked [8], dehydration certainly won't help you — so drink up, but don't overdo it. 

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