ACUTE BRONCHITIS CLINICAL PATHWAY CLINICAL DIAGNOSIS Cough for
ACUTE BRONCHITIS CLINICAL PATHWAY
CLINICAL DIAGNOSIS �Cough for 1 week or more, productive of purulent sputum may suggest acute bronchitis � Fever, chills, dyspnea easy fatigability and hoarseness may or may not be present
HOSPITAL ADMISSION �Confinement is not usually needed
DIAGNOSTIC EXAMINATION �No routine laboratory tests are needed for uncomplicated acute bronchitis. �Chest xray may be done to rule out other causes
ACUTE BRONCHITIS CLINICAL PATHWAY Cough >1 week with purulent sputum ± fever, chest discomfort, dyspnea & hoarseness ± crackles/ronchi/wheezes Chest x-ray ABNORMAL Other diagnosis NORMAL Treat as Bronchitis Treatment options for Bronchitis (Alone or in combination) ANTITUSSIVES BRONCHODILATORS (if bronchospastic) (e. g. β 2 agonist) ANTI-INFLAMMATORY (if with persistent cough) (e. g. oral or inhaled corticosteroids) MUCOLYTIC (e. g. Erdostein, Carbocisteine) If with no improvement Do repeat CXR after 5 -7 days of treatment especially if with fever, chest pain and pleurisy ANTIBIOTICS (e. g. Macrolides)
Cough >1 week with purulent sputum ± fever, chest discomfort, dyspnea & hoarseness ± crackles/rhonchi/wheezes Chest x-ray ABNORMAL Other diagnosis NORMAL Treat as Bronchitis
Treatment options for Bronchitis (Alone or in combination) ANTITUSSIVES BRONCHODILATORS (if bronchospastic) (e. g. β 2 agonist) ANTI-INFLAMMATORY (if with persistent cough) (e. g. oral or inhaled corticosteroids) MUCOLYTIC (e. g. Erdostein, Carbocisteine) If with no improvement Do repeat CXR after 5 -7 days of treatment especially if with fever, chest pain and pleurisy ANTIBIOTICS (e. g. Macrolides)
MONITORING RESPONSE TO THERAPY �Prognosis is good and special monitoring or referral for specialty care is not required
REFERENCES �Philhealth HTA Committee, Proceedings Workshop on the Critical Appraisal of Clinical Practice Guidelines and Development of Policy Statements. Sept 19 -21, 2005 �Light, Mathay; Chest Medicine, 1995
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