Respiratory diseases, including the bronchitis, can be of viral or bacterial etiology. Antibiotics are suitable only for the treatment of bacterial bronchitis. The correct choice of antibiotics and, therefore, favorable outcome in patients with respiratory disease is determined by three factors:
• type of pathogen infection;
• sensitivity of respiratory pathogens to the antibiotic;
• distribution and penetration of the drug in the sputum, bronchial mucosa and bronchial glands, and lungs parenchyma.
Patients should better take antibiotics as early as possible, when the first signs of the disease manifest. Treatment of a respiratory disease should be comprehensive, individualized and continuous. Before beginning the therapy, it is important to eliminate external factors that trigger the disease progression, like smoking, inhalation of harmful substances and others.
The grounds for the antibiotics prescription are clinical signs, indicative of the bacterial nature of bronchitis:
• dyspnea
• purulent sputum
• fever lasting more than 5 days
• tachycardia (pulse rate more than 100 beats per minute)
Only a medical specialist has the right to choose antibiotics for bronchitis. Dosage is adjusted individually for each patient. The treatment duration depends on the disease severity and the tolerability of the drug.
The effectiveness of antibiotics for the treatment of bronchitis is associated with:
• prevention of the disease complications
• direct exposure over microorganisms-pathogens
• fast disappearance of symptoms and reduction of the recovery terms
The expediency of using antibiotics for acute respiratory infections, including bronchitis, is beyond doubt. Nevertheless, cases of complications and undesirable reactions during the treatment are not an uncommon thing.
Disadvantages of using antibiotics for the treatment of bronchitis:
• higher risk of immuno-biological reactions;
• allergic reactions, including heavy ones;
• risk of microbial drug resistance.
The use of antibiotics for the treatment of bronchitis reduces the risk of disease progression and the development of pneumonia. Timely treatment initiation significantly reduces the terms of the patient’s recovery and reduces the risk of complications caused by the bacterial infection.
A common bronchitis complication is acute bacterial exacerbation of chronic obstructive pulmonary disease (COPD). Antibiotics of choice for the treatment of bronchitis with COPD are Amoxicillin or Amoxicillin/Clavulanate, and Cefixime. However, frequent use of antibiotics for bronchitis with COPD increases the risk of antibiotic resistance of microorganisms.
Drugs of choice for the treatment of bacterial bronchitis are macrolide (Erythromycin, Spiramycin, Clarithromycin) and beta-lactam (Penicillins, Cephalosporins, Carbapenems, Monobactams) antibiotics.
The effectiveness of macrolide antibiotics for the treatment of bronchitis is due to:
• activity against atypical respiratory pathogens;
• pharmacological activity against the majority of main respiratory pathogens;
• favorable pharmacokinetic characteristics.
Beta-lactam antibiotics are highly effective against typical bacterial pathogens. Yet they are powerless against atypical microorganisms-pathogens of the disease.
Antibiotics are equally effective for the treatment of bronchitis in patients of all ages. Use of antibiotics for bronchitis in elderly may insignificantly extend the recovery time.