Acute bronchitis is inflammation of the large airways, almost always caused by a virus, that leads to a cough lasting up to 3 weeks. It gets better on its own, and the main task is to rule out pneumonia and to avoid unneeded antibiotics.
Key symptoms
- Cough, with or without sputum, for 1 to 3 weeks
- Mild fever, sore throat and runny nose at the start
- Chest soreness from coughing
- Mild wheeze or shortness of breath
What you find on exam
- Normal or mildly raised vital signs
- Scattered wheezes or rhonchi that may clear with coughing
- No focal crackles, dullness or signs of consolidation
- Check oxygen saturation
Tests
- Usually no tests are needed
- Chest X-ray if heart rate over 100, breathing over 24, fever over 38 C or focal signs
- Influenza or COVID-19 testing when it changes treatment
- Pertussis testing for a severe or whooping cough
Treatment basics
- Explain that the cough can last 3 weeks and antibiotics do not help
- Rest, fluids, honey for cough in adults and children over 1 year
- Acetaminophen or ibuprofen for fever and aches
- An albuterol inhaler if wheezing
- Antivirals for influenza in high-risk patients; antibiotics for pertussis
Red flags
- Low oxygen or shortness of breath at rest
- High fever with focal lung findings, suggesting pneumonia
- Coughing blood or cough lasting more than 3 weeks
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; NCSBN 2026 NCLEX-RN Test Plan. Written by Making Synapses. Making Synapses is not affiliated with these organizations.