Antibiotics for acute bronchitis

Examples

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Brand Name	Generic Name
Dispermox	amoxicillin

Brand Name	Generic Name
Zithromax	azithromycin

Brand Name	Generic Name
Biaxin XL	clarithromycin

Brand Name	Generic Name
Vibramycin	doxycycline

Brand Name	Generic Name
Ery-Tab	erythromycin

Brand Name	Generic Name
Sulfatrim	trimethoprim and sulfamethoxazole combination

How It Works

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Antibiotics slow or stop the growth of bacteria or kill them.

Why It Is Used

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If you have no other health problems, experts recommend that antibiotics not be used for acute bronchitis.¹ Whether your doctor prescribes antibiotics and what type depend on the type of infection you have, your age, any other medical conditions you have, and your risk of complications from acute bronchitis, such as pneumonia.

How Well It Works

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Research on antibiotics and acute bronchitis reports that:²

• Antibiotics reduce coughing slightly, but most people who have bronchitis improve without antibiotics.
• In people who also have symptoms of a common cold but have no signs of pneumonia, antibiotics generally are not effective.

Side Effects

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Different types of antibiotics have different side effects. Common side effects include:

• Diarrhea.
• Nausea.
• Upset stomach.
• Vomiting.
• Sore mouth.
• Skin rash.
• Dizziness or headache.
• Increased sensitivity to sun (sunburn easily).
• Vaginal yeast infection.

A recent large study indicates that people who take erythromycin along with certain common medicines may increase their risk of sudden cardiac death.³ The study showed that the risk of sudden cardiac death is greater when erythromycin is taken with some medicines that inhibit certain liver enzymes—such as certain calcium channel blockers, certain antifungal medicines, and some antidepressants—than when these medicines are not taken together.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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The benefits of antibiotics for acute bronchitis are small and must be weighed against the risk of side effects and the possibility of antibiotic resistance.

If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Although smokers with acute bronchitis receive antibiotics more than nonsmokers, antibiotics are no more effective in smokers than in nonsmokers.⁴

If you have pneumonia or a chronic respiratory disease, such as chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis, or bronchiectasis, other antibiotics may be used.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Gonzales RG, et al. (2001). Principles of appropriate antibiotic use for treatment of uncomplicated acute bronchitis: Background. Annals of Internal Medicine, 134(6): 521–529.

2. Fahey T, et al. (2004). Antibiotics for acute bronchitis. Cochrane Database of Systematic Reviews (4). Oxford: Update Software.

3. Ray WA, et al. (2004). Oral erythromycin and the risk of sudden death from cardiac causes. New England Journal of Medicine, 351(11): 1089–1096.

4. Wark P (2008). Bronchitis (acute), search date July 2006. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.

Credits

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Author	Maria G. Essig, MS, ELS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Robert L. Cowie, MB, FCP(SA), MD, MSc, MFOM - Pulmonology
Last Updated	July 23, 2008