Antibiotics for acute bronchitis

Examples

Generic Name	Brand Name
amoxicillin	Amoxicot, Amoxil, Biomox, Dispermox
azithromycin	Zithromax
clarithromycin	Biaxin, Biaxin XL
doxycycline	Doryx, Monodox, Vibramycin
erythromycin	Eryc, EryPed, Ery-Tab
trimethoprim and sulfamethoxazole combination	Bactrim, Septra, Sulfatrim

How It Works

Antibiotics slow or stop the growth of bacteria or kill them.

Why It Is Used

If you have no other health problems, experts recommend that antibiotics not be used for acute bronchitis.¹ Whether your health professional prescribes antibiotics and what type depend on the type of infection you have, your age, any other medical conditions you have, and your risk of complications from acute bronchitis, such as pneumonia.

How Well It Works

Research on antibiotics and acute bronchitis reports that:^{2, 3}

• Antibiotics modestly reduce cough after 1 to 2 weeks, but have no effect on night cough, a cough that brings up mucus, or quality of life.
• In people who also have symptoms of a common cold and have been ill less than a week, antibiotics generally are not effective.
• Azithromycin was no more effective than vitamin C when people were asked about health-related quality of life.

Side Effects

Different types of antibiotics have different side effects. Common side effects include:

• Diarrhea.
• Nausea.
• Upset stomach.
• Vomiting.
• Sore mouth.
• Skin rash.
• Dizziness or headache.
• Increased sensitivity to sun (sunburn easily).
• Vaginal yeast infection.

A recent large study indicates that people who take erythromycin along with certain common medications may increase their risk of sudden cardiac death.⁴ The study showed that the risk of sudden cardiac death is greater when erythromycin is taken with some medications that inhibit certain liver enzymes—such as certain calcium channel blockers, certain antifungal medications, and some antidepressants—than when these medications are not taken together.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

The benefits of antibiotics for acute bronchitis are small and must be weighed against the risk of side effects and the possibility of antibiotic resistance.

If your health professional prescribes antibiotics, take the entire prescription. Don't stop taking the medication when you start to feel better. If you do not take the entire prescription, the bacteria causing the infection may not be entirely destroyed. The bacteria may grow again and make you sick, or the bacteria may become resistant to the antibiotic so that the antibiotic may not work the next time it is used.

Although smokers with acute bronchitis receive antibiotics more than nonsmokers, antibiotics are no more effective in smokers than in nonsmokers.²

If you have pneumonia or a chronic respiratory disease, such as chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis, or bronchiectasis, other antibiotics may be used.

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Author:	Sabra L. Katz-Wise	Last Updated: August 31, 2006
Medical Review:	Kathleen Romito, MD - Family Medicine Robert L. Cowie, MB, FCP(SA), MD, MSc, MFOM - Pulmonology
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