Acute bronchitis: clinical guidelines

The article deals with the issues of epidemiology and pharmacotherapy of acute bronchitis in adults. Acute bronchitis is one of the most pressing challenges in modern pulmonology, which is associated with a high incidence reaching 30–40 ‰ every year. The data on the prevalence of the disease, current ideas on the etiology of acute bronchitis, and trends of pharmacotherapy are presented. Acute bronchitis is a disease of viral etiology and it is inappropriate to use antimicrobial drugs to treat this disease. The widespread use of antibiotics, on the contrary, is accompanied by several adverse events, increased cost of treatment and the rise of antibiotic resistance. A special attention is paid to the markers of inflammatory response such as C-reactive protein and procalcitonin, their role in deciding on the need for antibacterial therapy for this disease. The article provides a critical analysis of the options for using inhaled bronchodilators and steroids to treat acute bronchitis. The clinical picture of acute bronchitis may include an acute onset, the presence of symptoms caused by upper and lower respiratory events, symptoms of intoxication of varying severity. The primary symptom of acute bronchitis is a cough, which is usually productive, with the discharge of a small amount of mucous and, sometimes, purulent sputum. Among the recommended drugs to treat acute bronchitis are mucoactive drugs, as cough is the main symptom of this disease. The results of presented studies showed that the combination drugs had the most pronounced mucoactive effect in acute bronchitis. For example, a drug containing bromhexine hydrochloride, guaifenesin and salbutamol demonstrated greater efficacy in reducing the duration of cough than mucoactive drugs being compared in the study in patients with acute respiratory viral infections and a long history of smoking.