How Bronchitis Is Treated

Woman using an inhaler
What are your bronchitis treatment options?. bluecinema/E+/Getty Images

Acute and chronic bronchitis are treated with fundamentally different approaches, although there are a few treatments that can be used for both conditions. The cornerstone of therapy for both conditions is based on improving comfort, promoting optimal breathing and reducing the cough.

The most common treatments for acute bronchitis include rest and symptomatic treatment when the inflammation is the result of a viral infection.

When a bacterial infection is the cause of acute bronchitis, antibiotics may be used as well. Chronic bronchitis, on the other hand, is managed with medications that decrease inflammation of the bronchi, such as inhaled or oral steroids, as well as lifestyle modifications, such as smoking cessation.

Home Remedies and Lifestyle

If you are diagnosed with acute or chronic bronchitis, you will probably not need to be hospitalized for it. For both acute and chronic bronchitis, a large focus of your treatment is based on home remedies and lifestyle modifications.

  • 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 of your bronchi. 
  • Humidifiers: Using a humidifier may relieve discomfort when you have acute bronchitis, and sometimes this helps with chronic bronchitis as well. Humidifiers add moisture to the air, making it easier to breathe, loosening mucus and can even relieve some of the pain that ensues from from breathing dry air.

    Acute Bronchitis

    • 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. 
    • 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

      A number of 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 doctor will recommend prescription strength medication that has a more lasting effect for chronic bronchitis. 

      • Decongestants: Decongestants, such as pseudoephedrine (Sudafed) and oxymetazoline (Afrin), loosen and help drain the mucus that may be in your sinuses, making it easier for you to breathe. There is some controversy about abuse of these medications, so it is important to be responsible and to use them conservatively. Use decongestants only if they relieve your symptoms, and for no longer than a few days at a time. 
      • 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 the recommended  doses, and be sure to tell your doctor or your child's pediatrician about over-the-counter medications that you are using. 
      • Cough medicationsCough suppressants or expectorants may be helpful if your cough is dry or unproductive. If you have a persistent cough of chronic bronchitis, your doctor may give you a prescription cough suppressant. 

      Prescriptions

      Prescription treatments for bronchitis are given for comfort, and some prescription treatments can help the disease itself to get better. 

      • Antibiotics: Most cases of acute bronchitis are caused by viral infections, which means that they cannot be treated with antibiotics. Viral infections do not improve with antibiotics, so taking them will not help you get better any faster, and can lead to other problems, such as antibiotic resistance.​ 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. If you do need to take antibiotics, be sure to take all of your medication as prescribed and do not stop just because you are feeling better.
      • Bronchodilators: Bronchodilators such as albuterol (Proventil), 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. Often used as inhalers, 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.
      • Steroids: 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. 
      • Phosphodiesterase-4 (PDE4) inhibitors: PDE4 inhibitors Daliresp (roflumilast) are a class of medication that treats inflammation associated with lung disease. A once-daily oral medication, PDE4 inhibitors help reduce exacerbation of chronic bronchitis, typically with minimal side effects.

      Surgeries and 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 which 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 is a technique that 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. The devices have been shown to improve results compared to physiotherapy and drainage alone. They are relatively affordable and easy to use, and your therapist or doctor may recommend a device for you if you have chronic broncitis.

      Complementary Alternative Medicine (CAM)

      There are a number of alternative therapies used for bronchitis, and few have been subjected to research, with limited, but promising, results. 

      • Eucalyptus Oil:  Eucalyptus may possesses antiviral properties, and using the oil by a eucalyptus steam inhalation may decrease some of the symptoms of acute bronchitis .
      • Pelargonium sidoides: P. sidodes, also known as Umckaloabo, is an herbal remedy that may be effective in relieving symptoms in acute bronchitis.
      • Slippery Elm: Slippery elm, in tea form, tea may help relieve the sore throat that can be associated with bronchitis. Slippery Elm contains mucilage, a gel-like substance that may reduce inflammation. 

      Sources:

      Careddu D, Pettenazzo A. Pelargonium sidoides extract EPs 7630: a review of its clinical efficacy and safety for treating acute respiratory tract infections in children. Int J Gen Med. 2018 Mar 8;11:91-98. doi: 10.2147/IJGM.S154198. eCollection 2018.

      Elaissi A, Rouis Z, Salem NA. Chemical composition of 8 eucalyptus species' essential oils and the evaluation of their antibacterial, antifungal and antiviral activities. BMC Complement Altern Med. 2012 Jun 28;12:81. doi: 10.1186/1472-6882-12-81.

      Timmer A, Günther J, Motschall E, Rücker G, Antes G, Kern WV. Pelargonium sidoides extract for treating acute respiratory tract infections. Cochrane Database Syst Rev. 2013 Oct 22;(10):CD006323. doi: 10.1002/14651858.CD006323.pub3.