How Long Will Bronchitis Last After Antibiotics?

When treated, acute bronchitis itself could be alleviated in less than a week.

The cough however, could last for as long as 15-18 days after treatment. Mostly because the respiratory pathways need more time to heal from the irritation and inflammation caused by bronchitis. 

A complete overview of bronchitis

Bronchitis is simply an inflammation of the bronchial tubes or breathing pathways. This inflammation is what gives rise to the difficulties and sometimes pain associated with coughing. The inflammation caused by acute bronchitis also causes swelling of the lungs and accumulation of mucus. The lungs then put in extra effort to clear all of the extra mucus by forced contractions. This is what leads to the cough that is the key symptom of bronchitis. 

The pain associated with coughing is why people frequently confuse acute bronchitis with other respiratory tract infections such as whooping cough. 

Bronchitis is a relatively common and recurring disease. It is one of the most common respiratory tract infections. The cough occurring as a result of bronchitis is usually productive. This means that there is significant mucus expulsion after each coughing bout. 

Types of bronchitis

There are two types of bronchitis. 

Acute bronchitis

Acute bronchitis is simply s short term or short-lasting bronchitis. According to the National Health Service (NHS), this type of bronchitis usually lasts up to 3 weeks.¹ This is the type of bronchitis that usually occurs after seasonal infections such as flu. Acute bronchitis could also be as a result of a common cold or even a sore throat. 

Chronic bronchitis

This is also referred to as Chronic Obstructive Pulmonary Disease (COPD). Chronic bronchitis is more severe than acute bronchitis. This type of bronchitis lasts from several months to even years. This sort of bronchitis is usually as a result of years of accumulated damage to the breathing pathways. 

The NHS describes it as the type of bronchitis marked by a productive cough and lasting as long as two consecutive years. The NHS describes chronic bronchitis as one of the many respiratory inflammatory diseases that makes up Chronic Obstructive Pulmonary Disease (COPD).¹

Causes

The major cause of acute bronchitis is usually viral or allergy related. According to reports by the Centers for Disease Control and Prevention (CDC), bronchitis is rarely as a result of bacterial infection.² Thus it is not a reason for antibiotic treatment. There are 3 major causes of acute bronchitis according to the NHS. They are:¹

1. Mostly viral and less often bacterial in origin.
2. Inhalation of irritant objects.
3. Occupational exposure to air pollution and lung irritants such as ammonia, strong acids, chlorine, etc. 

According to the National Heart, Lung, and Blood Institute (NHLBI), chronic bronchitis and COPD are mostly as a result of smoking.³ Most people who suffer from chronic bronchitis either: 

• Smoke or are regularly exposed to secondhand smoking or
• Are regularly exposed to fumes 

There are certain groups of people who are more disposed to chronic bronchitis. They include:

• The elderly
• Those with history respiratory complications in their childhood
• First hand and second hand smokers
• Those with gastrooesophageal reflux disease (GORD).³

Symptoms of bronchitis (Brief)

Other than their varying durations, acute and chronic bronchitis share similar symptoms. 

• Productive or chesty cough (sometimes without mucus)
• Sore throat
• Fatigue (almost overwhelming feeling of tiredness)
• Watery eyes
• Runny or blocked nose
• Body/ joint pains
• Mild but persistent headaches 

Whooping cough symptoms and shortness of breath are more characteristics of chronic bronchitis.³ However, this is more common with longer duration chronic bronchitis. So the wheezing and difficulty breathing only sets in after a few months of chronic bronchitis.

Diagnosis of bronchitis

There is no clear cut diagnostic method for identifying bronchitis. Its diagnosis is instead done by ruling out all other respiratory tract infections and diseases. The healthcare providers particularly take caution in ruling out pneumonia and acute asthma. Tests done to achieve this elimination phase include:

Chest X-rays 

This is done to get an image of the lungs and its lining. If the image is clear, one can rule out pneumonia.

Culture of Nasal Discharge and Sputum

This is done to confirm any bacterial infection and the exact organism involved. It is usually only carried out when a patient has a history or respiratory bacterial infection.

Treatment for bronchitis

The CDC mentions that even in cases where bacterial involvement is observed in acute bronchitis, the application of antibiotic treatment is not ideal.² Generally, bronchitis is self-sustaining which means that it usually resolves itself. The outlined treatment methods are only used when it has been confirmed that the bronchitis is not as a result of underlying health problems. 

Some of the recommended treatments for acute bronchitis are:

1. Increased Fluid Intake: Intake of lots of fluid (preferably warm water) significantly aids in alleviating the symptoms. The fluid intake is also essential because it serves as a mucolytic (helps to thin the mucus in throat and lungs). This will make it easier to expel the mucus and provide soothing relief from violent coughing bouts. 
2. Use of Honey: This is especially useful in kids below six years old. The Medicines and Healthcare products Regulatory Agency (MHRA) discourages use of over-the-counter cough syrups for children below 6.1 Honey has been found to be an excellent remedy to nighttime coughs in children. Just 10ml before bedtime significantly decreases the frequency of cough bouts at night. Mixed with lemon water, the effects are even more notable. This remedy also works for adults. Honey has been found to have a soothing effect on the upper respiratory tract which reduces irritation and therefore alleviates violent coughing. It is the go-to home remedy for treatment of bronchitis.
3. Use of Over-the-Counter Cough Syrups: These are useful in quickly alleviating the symptoms of bronchitis. While the cough might persist for up to 3 weeks, you should feel better after a few days of using cough syrups. Depending on what you can get, some are used as expectorants (facilitate coughing and easy mucus expulsion).
4. Cough Suppressant: These cough suppressants work by providing relief from violent coughing bouts by soothing the respiratory tract linings. 
5. Use of Bronchodilators: This approach is usually taken for chronic bronchitis. These bronchodilators help keep the airways open by relaxing related muscles. These are used in situations when a patient suffers from shortness of breath. They are usually short-acting or long-acting and should be taken only when prescribed by a physician. 
6. Corticosteroids: These are also used especially in chronic cases. These corticosteroids help sooth the swelling and inflammation along the airways. These drugs are usually taken together with the bronchodilators. An example is prednisolone. 
7. Avoid smoking or irritating fumes.
8. Do not use antihistamines. This is because they could lead to drying of secretions and making the cough dry. This could generally lead to worsening of symptoms. 

When are antibiotics recommended for bronchitis?

Antibiotics are only recommended for treatment of bronchitis when bacterial activity has been confirmed. Cleveland Clinic recommends use of antibiotics when there is worsening or potential worsening of symptoms (such as breathlessness or coughing) resulting from a bacterial infection.⁴

Side effects of antibiotics

The side effects vary based on antibiotics used, mode of administration and patient. 

For oral doses the reactions could be nausea and vomiting. The reactions could be mild such as rashes. To more severe allergic reactions and health complications (such as antibiotic resistance).

How long will bronchitis last after antibiotics?

As long as the bronchitis is as a result of bacterial infection, then antibiotics will have their desired effect anywhere from 3 to 7 days. Depending on the antibiotic in use and dosage. 

The cough itself however, might last up to 15 days. But its frequency will significantly reduce with time. By the second week it will be more of a tickling feeling than actual coughing bouts.

Is bronchitis not contagious while taking antibiotics?

Bacterial- and viral-based bronchitis will remain contagious until the treatment is over. So until the physician-recommended antibiotic regimen is completed, one can assume that bronchitis is still contagious. 

Self-care for bronchitis

The self-care approach for bronchitis is relatively straightforward. The tips include:

1. Always stay hydrated
2. In the event of mild aches, start with a simple over the counter analgesic such as paracetamol. 
3. Use honey and lemon water mixture 
4. Rest a lot. Take a few days off so that your body can recover. 

Complications of bronchitis

The most common complications of bronchitis are:

• Pneumonia 
• Asthma
• Chronic Obstructive Pulmonary Disease
• Lung Disease

When to see a doctor

There are certain bronchitis symptoms to look out for before running to the doctor. They include:

• Odd coloured mucus
• Fever higher than 390C or 102°F for more than 72 hours
• Wheezing 
• Shortness of breath and dizziness
• Blood spots in expelled mucus

To be on the safe side, once you experience symptoms you’re not quite sure of, visit the nearest health physician.

Summary

If there is a need to use antibiotics to tackle your bronchitis, then the bronchitis will be cleared in a few days. However the symptoms might take longer to be alleviated as the inflammation or swelling in the airways might take some extra time to completely heal.