ACUTE BRONCHITIS CLINICAL PATHWAY

CLINICAL DIAGNOSIS

Cough for 1 week or more, productive of purulent sputum may suggest acute bronchitis

Fever, chills, dyspnea easy fatigability and hoarseness may or may not be present

HOSPITAL ADMISSION

Confinement is not usually needed

DIAGNOSTIC EXAMINATION

No routine laboratory tests are needed for uncomplicated acute bronchitis.

Chest xray may be done to rule out other causes

Cough >1 week with purulent sputum± fever, chest discomfort, dyspnea & hoarseness± crackles/ronchi/wheezes

Chest x-ray

ABNORMALOther diagnosis

NORMALTreat as Bronchitis

Treatment options for Bronchitis(Alone or in combination)

ANTITUSSIVES BRONCHODILATORS(if bronchospastic)(e.g. β2 agonist)

ANTI-INFLAMMATORY(if with persistent cough)

(e.g. oral or inhaled corticosteroids)

MUCOLYTIC(e.g. Erdostein, Carbocisteine)

ANTIBIOTICS(e.g. Macrolides)

Do repeat CXR after 5-7 days of treatment especially if with fever, chest pain and pleurisy

If with no improvement

ACUTE BRONCHITIS CLINICAL PATHWAY

Cough >1 week with purulent sputum± fever, chest discomfort, dyspnea &

hoarseness± crackles/rhonchi/wheezes

Chest x-ray

ABNORMALOther diagnosis NORMAL

Treat as Bronchitis

Treatment options for Bronchitis(Alone or in combination)

ANTITUSSIVES BRONCHODILATORS(if bronchospastic)(e.g. β2 agonist)

ANTI-INFLAMMATORY(if with persistent cough)

(e.g. oral or inhaled corticosteroids)

MUCOLYTIC(e.g. Erdostein, Carbocisteine)

ANTIBIOTICS(e.g. Macrolides)

Do repeat CXR after 5-7 days of treatment especially if with fever, chest pain and pleurisy

If with no improvement

MONITORING RESPONSE TO THERAPY

Prognosis is good and special monitoring or referral for specialty care is not required

REFERENCES

Philhealth HTA Committee, Proceedings Workshop on the Critical Appraisal of Clinical Practice Guidelines and Development of Policy Statements. Sept 19-21, 2005

Light, Mathay, Mathay; Chest Medicine, 1995