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ACUTE BRONCHITIS CLINICAL PATHWAY
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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
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HOSPITAL ADMISSION
Confinement is not usually needed
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DIAGNOSTIC EXAMINATION
No routine laboratory tests are needed for uncomplicated acute bronchitis.
Chest xray may be done to rule out other causes
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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
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Cough >1 week with purulent sputum± fever, chest discomfort, dyspnea &
hoarseness± crackles/rhonchi/wheezes
Chest x-ray
ABNORMALOther diagnosis NORMAL
Treat as Bronchitis
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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
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MONITORING RESPONSE TO THERAPY
Prognosis is good and special monitoring or referral for specialty care is not required
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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