Bronchitis occurs when the bronchial tubes, which carry air into the lungs, become inflamed and swell. This inflammation leads to excess mucus production and triggers a persistent, forceful cough. When the tubes are irritated, breathing can become labored or uncomfortable. Understanding this inflammation helps determine which medications will be most helpful.
Acute Versus Chronic Bronchitis
The kind of bronchitis a person has determines the appropriate course of treatment. Acute bronchitis, often called a chest cold, is typically a short-term condition lasting a few days to a few weeks. It is caused by the same viruses responsible for the common cold or the flu, meaning antibiotics are generally ineffective.
Chronic bronchitis is a serious, long-term condition defined by a productive cough that occurs on most days for at least three months a year for two consecutive years. This persistent inflammation is often linked to long-term exposure to irritants, with cigarette smoking being the leading cause. Chronic bronchitis is also a major component of Chronic Obstructive Pulmonary Disease (COPD) and requires continuous medical management.
Over-the-Counter Relief for Bronchitis Symptoms
For most cases of acute bronchitis, which are viral, treatment focuses on managing symptoms until the body clears the infection. One common category of over-the-counter (OTC) products is cough suppressants, such as dextromethorphan. These medications block the cough reflex in the brain and are most appropriate for a dry cough that interferes with sleep or daily activities.
When the cough is wet and productive, an expectorant like guaifenesin may be more helpful. Guaifenesin works by thinning the mucus in the airways, making it easier to cough up and clear from the chest. Using a cough suppressant with a productive cough is generally not recommended because it prevents the body from clearing the loosened mucus.
General pain and fever reducers provide relief for the body aches, headache, and low fever that often accompany acute bronchitis. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are commonly used. Simple supportive care is also effective; remaining well-hydrated and getting plenty of rest helps the body recover and aids in keeping mucus thin.
When Prescription Treatment Is Required
Prescription medication is necessary when symptoms are severe, a bacterial cause is confirmed, or the condition is chronic. Antibiotics are only effective against bacterial infections, so they are not a standard treatment for viral acute bronchitis. A doctor may prescribe them if a bacterial infection is suspected or confirmed, or for patients with an acute flare-up of chronic bronchitis who are at risk of complications.
For patients who experience wheezing or shortness of breath, bronchodilators may be prescribed to relax the muscles around the airways. Medications like albuterol are delivered via an inhaler and work to open the bronchial tubes, making breathing easier. This treatment is common for those with underlying conditions like asthma or COPD, which often accompany chronic bronchitis.
Corticosteroids, either inhaled or oral, are sometimes used to reduce inflammation. Inhaled steroids are often part of the maintenance therapy for chronic bronchitis, sometimes paired with a long-acting bronchodilator. Oral steroids may be used briefly during a severe acute episode or an exacerbation of chronic disease. If a cough lasts longer than three weeks, or if a high fever (above 100.4°F), worsening shortness of breath, or blood in the mucus appears, a medical consultation is necessary.