Acute Cough, Bronchitis

Note 

  • Avoid tetracyclines in pregnancy.
  • Low doses of penicillins are more likely to select out resistance.
  • The quinolones ciprofloxacin and ofloxacin have poor activity against pneumococci. However, they do have use in PROVEN pseudomonal infections. Moxifloxacin and
  • Levofloxacin has some anti-Gram-positive activity but should not be needed as first line treatment

Note 

Doses are oral and for adults unless otherwise stated. Visit the Health Products Regulatory Authority website for drug SPCs, dosage, contraindications, interactions, or IMF/BNF/BNFC/MIMS. See guidance on dosing in children for quick reference dosage/weight guide.

Letters indicate strength of evidence range from A+ (systematic review) to D (informal opinion). Statins can interact with some antibiotics and increase the risk of rhabdomyolysis. Amiodarone and drugs which prolong the QT interval can interact with many antibiotics. Many antibiotics increase the risk of bleeding with anticoagulants. Please refer to our Drug Interactions Table for further information.

Comments

  1. In primary care, antibiotics have marginal benefits in otherwise healthy adults. A+
  2.  Patient leaflets can reduce antibiotic use. B+

Symptomatic relief

  • Cough expectorants: guaifenesin
  • Mucolytic agent: carbocisteine
  • Cough suppressants: dextromethorphan
  • Codeine containing products should be used with care due to dependence potential

Treatment

Consider no antibiotics where possible. A+ 

If antibiotics deemed clinically indicated:

Treatment Adult Dose TX Duration
amoxicillin 500 mg TDS 5 days
OR doxycycline 200 mg stat/100 mg OD 5 daysP

See guidance on dosing in children for quick reference dosage/weight guide


Patient Information

The HSE Health A-Z website provides patient information on many hundreds of conditions and treatments.

Click here to view information about Bronchitis

We recommend patients use the website developed by HSE/ICGP/IPU partnership www.undertheweather.ie for tips on how to get better from common infections without using antibiotics, what you can do for yourself or a loved one and when to seek help.

Reviewed June 2016


Patient Information

Visit HPSC Information Leaflets pages for the General Public, (MRSA, CRE, etc)


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