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Chest infections - adult - Management
How should I follow up a person with acute bronchitis?
- Routine follow up is not necessary. However, advise the person to seek advice if their condition deteriorates significantly or symptoms persist for longer than 3 weeks.
- At follow up, consider other diagnoses and rule out serious causes of symptoms (including developing pneumonia). If the person has already received a course of antibiotics (due to a pre-existing condition), consider watchful waiting (especially if the condition has not deteriorated), or treat with a second-line antibiotic.
- Co-amoxiclav gives cover against beta-lactamase-producing organisms. Doxycycline gives cover against some atypical pathogens (e.g. Mycoplasma pneumoniae and Chlamydia pneumoniae).
- If these antibiotics are unsuitable, seek advice from a microbiologist (a macrolide or fluoroquinolone may be recommended).
- Consider admission if the person significantly deteriorates whilst taking oral antibiotics.
- After the person has recovered from acute bronchitis, consider whether pneumococcal or influenza immunization is necessary. See the CKS topics on Immunizations - pneumococcal and Immunizations - seasonal influenza.
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