Will Antibiotics Help Bronchitis?

Introduction

What is Bronchitis?

Bronchitis is an infection and inflammation in the bronchi, which is the main airway of the lungs. Inflammation of the bronchial tube’s lining leads to producing more mucus than normal, causing lower breathing efficiency. Coughing is the technique your body uses to expel excessive mucus to allow easier breathing.³

Types of bronchitis

There are two types of Bronchitis:

Chronic bronchitis

Chronic bronchitis is defined as a long-term inflammation and irritation of the bronchi.⁶ A cough that lasts three months a year for two consecutive years is a common symptom in people with chronic bronchitis.⁸

The inflammation and cough could be caused by initial illness or respiratory infection, tobacco exposure, or any other irritating pollutants in the air. Chronic bronchitis can result in airflow blockage, which is classified as a chronic obstructive pulmonary disease (COPD).⁶

Acute bronchitis

Acute bronchitis is a short-term inflammation of the airways that causes a cough and mucus. It can persist for up to three weeks.⁴ A viral infection is one of the main causes of acute bronchitis inflammation.⁶ Adenovirus, influenza A and B viruses, respiratory syncytial virus, parainfluenza virus, and rhinovirus are the most common respiratory viruses.¹⁶ Smoking is another cause of acute bronchitis that can exacerbate its symptoms. It's more common in the winter and usually follows a common cold, flu, or sore throat.

Causes and symptoms

Viral and Bacterial Infections 

Viral infection is the most common cause of bronchitis, though bacterial infection can also occur but is less common. Viruses that cause the flu or the common cold may also cause bronchitis. When someone sneezes or coughs, millions of little droplets that contain the virus fall out of their mouth and nose. The droplets normally spread to 1 meter and hang in the air for a time before landing on a surface, where they can last up to 24 hours. Anyone who comes in contact with the infected surface and subsequently touches something else can readily spread the virus.³

Physical or chemical agents inhaled

Inhaling irritant substances, such as heavy fumes, cleaning products, or tobacco cigarette smoke, can induce bronchitis. Smoking cigarettes is thought to be the primary cause of chronic bronchitis. Both smokers and second-hand smoke inhalers are at risk for chronic bronchitis. Chronic bronchitis patients are more likely to suffer emphysema which is a smoking-related lung illness that happens when the air sacs in the lungs are destroyed, causing shortness of breath.³

Occupational Exposure 

Exposure to materials that harm the lungs, such as ammonia, strong acids, chlorine, grain dust, and textiles (fabric textiles), increases the risk of developing chronic bronchitis or any other chronic obstructive pulmonary disease (COPD). This is sometimes known as occupational bronchitis, and it normally goes away once the person is no longer exposed to the irritating material.

Antibiotics for bronchitis

Zithromax (azithromycin)

Zithromax, commonly known as azithromycin (Z-pak), is an antibiotic that is used to treat many bacterial infections, such as skin and respiratory infections. Z-pak treats bacterial infections by preventing bacterial growth in the body. The drug is used to treat diseases including pneumonia, bronchitis, and infections of the lungs, ears, and other organs during a five-day period.¹⁸ Z-paks usually do not cause any side effects in patients. However, the most common adverse effects were gastrointestinal such as nausea, stomach discomfort, and diarrhoea. The intensity of the side effects increases with higher doses.¹⁸

Fluoroquinolones

Fluoroquinolones are an antibiotic class that is used to treat specific bacterial infections. It include levofloxacin (Levaquin), ciprofloxacin (Cipro), gemifloxacin (Factive), ofloxacin (Floxin) and moxifloxacin (Avelox).¹⁰  However, the U.S. Food and Drug Administration (FDA) doesn’t recommend the usage of fluoroquinolones in the treatment of respiratory and urinary tract infections due to those antibiotics' serious side effects.

Aminopenicillins

Aminopenicillins are a type of penicillin antibiotic with an additional amino group that boosts antibacterial activity. These antibiotics are used to treat a variety of infections, including those of the skin, gastrointestinal tract, urinary tract, and lungs.¹⁵ Nausea, diarrhoea, skin rash, vomiting, sleeplessness, heartburn, and discomfort at the injection site are some of the most common adverse effects.¹⁵

Cephalosporins

Cephalosporins are broad-spectrum antibiotics, similar to penicillin, in that mode of action that is given to treat a variety of bacterial infections.¹⁴ They inhibit enzymes involved in the production of peptidoglycan, a key component of the bacterial cell wall.¹¹ Cephalosporins have few negative effects in most cases. Abdominal pain, diarrhoea, dyspepsia, headache, gastritis, nausea, and vomiting are among the most commonly reported side effects. There are some reports about transient liver issues.¹¹

How do antibiotics help to treat bronchitis?

Antibiotics are rarely recommended for patients with bronchitis who do not have any other health problems. It may relieve coughing, but it has certain negative effects and may lead to antibiotic resistance. Antibiotics may be prescribed for bronchitis if the individual has:

• Asthma.
• COPD.
• Cystic fibrosis.
• Heart failure. 
• Still unwell after 3 months.
• At risk for pneumonia.⁵

Benefits of antibiotics 

• Antibiotics are used as therapy for bacterial infections.
• They can be used as a preventive rather than a treatment in some cases, such as protection of patients having surgical operations, protection of people with critical health problems and prevention of specific bites and wound infections.²
• Antibiotics are quick-acting; many antibiotics start working within a few hours.
• They are easy to take and are usually administered orally.¹³

Side effects

Antibiotic side effects can vary from mild responses to severe and deadly complications. Most antibiotics are quite safe and with minimal adverse effects when used correctly.

Antibiotics used to treat bronchitis commonly cause the following adverse effects:

• Nausea.
• Rash. 
• Watery or bloody diarrhoea.
• Allergic reaction to antibiotics.
• Stomach cramps.
• An antibiotic-resistant infection.
• Yeast infections in the mouth or vagina (discharge and intense itching in the vaginal area, as well as white spots or mouth sores in the mouth or on the tongue).¹

How effective are antibiotics

Antibiotics treat bacterial infections by either killing them or slowing and stopping bacterial growth. They achieve this by targeting the bacterial cell wall disrupting its reproduction, and preventing protein synthesis in bacteria.¹²

Antibiotics become effective as soon as they are administered. Although, it is possible not to feel better for another 2 to 3 days. The length of time for recovery after starting antibiotic treatment varies.¹²

Antibiotics should be administered for 7 to 14 days in most cases. When antibiotics are used correctly, they are most effective.¹² Even if you feel better after a few days of therapy, it's crucial to continue the antibiotic programme to get rid of the illness completely. This will also assist in the prevention of antibiotic resistance. 

Home remedies for Bronchitis

Several therapies, including natural remedies, may help alleviate symptoms of bacterial or viral bronchitis. There are some pieces of advice that help to relieve bronchitis symptoms: 

• Rest.  
• Drink plenty of fluids.
•  If you have a congested nose use a saline nasal spray, a humidifier or inhale steam from a hot shower or bath. Warm, humid air aids in cough relief and loosens mucus in the airways .¹⁷
• Think about wearing a face mask. Put on a cold-air face mask before heading outside, as cold air can exacerbate coughing and cause shortness of breath.
• Irritants to the lungs should be avoided. Avoid smoking.
• Over-the-counter pain medicines can be used to treat some of the sore throat and sore chest symptoms.

Complications

The major complications of chronic bronchitis are:

• Pneumonia.
• Respiratory failure.
• Chronic Obstructive Pulmonary Disease (COPD).
• Enlargement and weakness of the right heart ventricle of the heart due to lung disease.
• Pneumothorax (accumulation of air or gas in the lungs causing the lungs to rupture).
• Polycythemia (A higher-than-normal concentration of red blood cells required to transport oxygen).
• Emphysema.
• High mortality rate.⁹ 

Summary

Antibiotics are quite effective in treating bacterial illnesses. However, they have very little impact on viruses and are ineffective against bronchitis. Over time, prescribing antibiotics when they are unneeded might cause bacterial resistance to treatment.