How Bronchitis Is Treated

Steroids for bronchitis may be prescribed in chronic cases to help decrease inflammation of the bronchi. Treatment for acute bronchitis usually involves a different approach, including rest and symptomatic treatment. When a bacterial infection is the cause, antibiotics may be prescribed as well.

Overall, the cornerstone of therapy for both forms is based on improving comfort, promoting optimal breathing, and reducing the cough.

This article discusses the various ways chronic and acute bronchitis are treated, including prescription medications, specialist procedures, complementary therapies, and at-home remedies.

Home Remedies and Lifestyle

If you are diagnosed with acute or chronic bronchitis, you will probably not need to be hospitalized. Acute bronchitis is the type that comes on suddenly and is often the result of a viral infection, while chronic bronchitis is long-lasting.

For both acute and chronic bronchitis, a large focus of your treatment is based on home remedies and lifestyle modifications.

You may be able to get over bronchitis more quickly by following these guidelines. Don't push yourself, even if that means taking time off from work and turning over household tasks and other responsibilities to others. You should also:

• Avoid smoke and fumes: Both acute and chronic bronchitis can be exacerbated by cigarette smoke, industrial inhalants, and fumes in the environment, such as smoke from a grill. Whenever possible, stay away from inhaled irritants, as they can induce an increased inflammatory reaction in your bronchi. 
• Use a humidifier: Using a humidifier may relieve discomfort when you have acute bronchitis, and sometimes this helps with chronic bronchitis as well. A humidifier adds moisture to the air, making it easier to breathe and loosening mucus. It can even relieve some of the pain that occurs when you breathe dry air.
• Rest: Acute bronchitis can cause you to feel very tired. This is due to both the infection and the persistent cough. It is important to rest as much as possible when you are sick. Research has found sleep makes it easier for immune cells to fight infection.
• Fluids: Drinking clear liquids when you have any type of respiratory infection is important because you need to stay hydrated, which helps thin the mucus in your chest and throat.

Over-the-Counter Therapies

Several over-the-counter medications can help relieve some of the symptoms of both acute and chronic bronchitis. In general, these medications are more effective for short-term use if you have acute bronchitis. Most of the time, your healthcare provider will recommend prescription-strength medication that has a more lasting effect on chronic bronchitis. 

• Pain relievers: Pain relievers and fever reducers such as acetaminophen and ibuprofen can help relieve the chest pain and soreness that you may experience from coughing when you have bronchitis.
• Fever reducers: Many of the medications that can reduce your fever also relieve mild pain, so these over-the-counter medications can do double duty. Do not take them in doses higher than recommended, and tell your healthcare provider or your child's pediatrician about over-the-counter medications that you are using. 
• Cough medications: Cough suppressants or expectorants may be helpful if your cough is dry or unproductive. If you have a persistent cough with chronic bronchitis, your healthcare provider may give you a prescription cough suppressant. 

Antibiotics

If you have acute bronchitis caused by a bacterial infection, you may need to take prescription antibiotics. The specific antibiotic is determined based on the likely bacterial organism.

Most cases of acute bronchitis are caused by viral infections, which means that they cannot be treated with antibiotics. Taking an antibiotic for viral bronchitis will not help you get better any faster and can lead to other problems, such as antibiotic resistance.

An exception is when acute bronchitis occurs in someone with asthma or other ongoing respiratory problems, including chronic obstructive pulmonary disease (COPD) and cystic fibrosis, as well as those with heart failure. Because bronchitis can lead to secondary infections in people with these conditions, healthcare providers will often prescribe antibiotics to lower the risk of pneumonia or other complications.

Steroids for Bronchitis

Oral steroids may be used to treat chronic bronchitis when symptoms rapidly get worse. Inhaled steroids are typically used to treat stable symptoms or when symptoms are slowly getting worse. 

Bronchodilators

Bronchodilators such as Proventil (albuterol) relax the muscles around the bronchi, allowing them to become wider. This helps remove bronchial secretions while relieving bronchospasm and reducing airway obstruction.

Your wheezing and chest tightness may temporarily improve, and more oxygen can be distributed to your lungs to improve your energy level. Some of these medications are referred to as rescue inhalers because they work quickly and are used to treat sudden episodes of shortness of breath related to bronchospasm.

PDE4 Inhibitors

Phosphodiesterase-4 (PDE4) inhibitors Daliresp (roflumilast) are a class of medication that treats inflammation associated with lung disease. They are only used for chronic bronchitis associated with severe COPD, not for acute disease. PDE4 inhibitors are taken once a day by mouth. They help reduce exacerbation of chronic bronchitis. Significant side effects, particularly weight loss, are possible with this medication.

Bronchitis Doctor Discussion Guide

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Specialist-Driven Procedures

Several procedures can help relieve the symptoms and congestion of chronic bronchitis. These procedures are primarily non-invasive and easy to tolerate but must be directed by an experienced specialist. 

• Chest physiotherapy: This procedure, which may also be referred to as chest percussion, is a technique that involves clapping on the chest and/or back to help loosen mucus and make it easier to cough up. It is often used with postural drainage and can be performed using cupped hands or an airway clearance device.
• Postural drainage: This technique uses gravity to assist with the removal of mucus from the airways. Both chest physiotherapy and postural drainage work best after a bronchodilator treatment.
• Airway clearance devices: These devices are used in conjunction with chest therapy and postural drainage to better ensure mucus clearance from the lungs. They have been shown to improve results compared to physiotherapy and drainage alone. They are relatively affordable and easy to use, and your therapist or healthcare provider may recommend one if you have chronic bronchitis.
• Positive expiratory pressure (PEP) devices allow you to breathe against air pressure.
• High-frequency oscillating devices, such as the Flutter mucus clearance device. Aerobika device, and Acapella vibratory PEP device, gently allow the small and large airways to vibrate.
• The Lung Flute, a hand-held device, generates low-frequency sound waves in the airways. The vibrations loosen mucus, making it easier to cough up.

Complementary Medicine (CAM)

There are several alternative therapies used for bronchitis. A few have been subjected to research, with limited results:

• Eucalyptus oil:  Eucalyptus may possess antiviral properties; using the oil with eucalyptus steam inhalation may decrease some of the symptoms of acute bronchitis. Notes that some oils can cause pneumonia or worsen lung disease, so these should be used only with caution.
• Pelargonium sidoides: Also known as umckaloabo, P. sidoides is an herbal remedy available as a syrup or oral solution that may be effective in relieving symptoms of acute bronchitis.
• Slippery elm: In tea form, slippery elm may help relieve a sore throat that can be associated with bronchitis. Slippery elm contains mucilage, a gel-like substance that may reduce inflammation. 

Summary

Bronchitis may be treated in different ways depending on whether it is acute or chronic. Acute bronchitis is often treated with home remedies like rest and staying hydrated. If the condition is caused by a bacterial infection or if there's a risk of secondary infection, it may also be treated with antibiotics.

Chronic bronchitis may be treated with steroids to help reduce inflammation. Bronchodilators and PDE4 inhibitors can also help. In some cases, a specialist procedure such as chest physiotherapy or postural drainage may be necessary.