Bronchitis

Where laboratory susceptibility reports recommend that increased dosing is required for specific antimicrobials in relation to organism susceptibility, please refer to local Adult High Dose Antimicrobial Regimens Based on Susceptibility Reporting guidelines.

Treatment of acute cough and bronchitis

In otherwise healthy individuals no antibiotic treatment

If >80 years of age and one of: hospitalisation in past year; taking oral steroids; insulin-dependent diabetics; congestive heart failure; or >65 years with 2 of the above.

Amoxicillin
Amoxicillin 500mg capsules

500mg every 8 hours for 5 days

Amoxicillin 250mg/5ml oral suspension sugar free

500mg every 8 hours for 5 days

For penicillin allergy or no response to amoxicillin.

Doxycycline
Doxycycline 100mg capsules

200mg on day 1, then 100mg daily for 5 days treatment in total

For penicillin allergy in pregnancy.

Erythromycin
Erythromycin 250mg gastro-resistant tablets

500mg every 6 hours for 5 days.

Erythromycin ethyl succinate 250mg/5ml oral suspension sugar free

500mg every 6 hours for 5 days.

Prescribing Notes:

  • Do not prescribe an antibiotic for uncomplicated coughs and colds when the infection is likely to be viral in nature- only use antibiotics when there is evidence of bacterial infection.
  • A higher dose of amoxicillin (1g every 8 hours) may be required for haemophyllus infections, please consult any susceptibility reports.
  • The vast majority of respiratory tract illness is self-limiting and it is recommended that the term “infection” is avoided. Purulent sputum alone is not a marker for antibiotic treatment.
  • Antibiotics are of limited benefit in acute cough and bronchitis if there are no other significant co-morbidities. Symptom resolution can take 3 weeks.
  • Most infective exacerbations of asthma do not require antibiotics.
  • Consider pertussis if prolonged acute cough lasting for 14 days or more without an apparent cause plus one or more of the following: paroxysmal cough, inspiratory 'whoop', post-tussive vomiting OR has clinical features and contact with confirmed case in previous 21 days.  See formulary recommendations for pertussis.  

History Notes

20/11/2024

New content agreed, ERWG Nov 2024.

10/10/2024

Prescribing information updated, ERWG Sep 24.

15/12/2021

East Region Formulary content agreed.