Acute Bronchitis in Adults

What Is Acute Bronchitis?

You know that nagging cough – the one that seems to linger for days or even weeks? It may be acute bronchitis, a respiratory tract infection that is usually a result of the common cold or flu (influenza) virus. Your doctor might call it a chest cold. Cough occurs when the airways in the lungs swell and produce mucus. So just how do you treat these nagging coughs?

Bronchitis is an inflammation of the bronchi — the main air passages to the lungs. Acute bronchitis usually does not need an antibiotic treatment, as it is viral in nature, often stemming from a cold or the flu, and is self-limiting. Typical symptoms may include chest congestion, a productive cough that lasts more than five days, fatigue, shortness of breath, and mild fever or chills.

Bronchitis can rarely lead to a more serious condition when there is a secondary bacterial infection, such as pneumonia, and may require medical treatment, antibiotics, and even hospitalization. If your cough lasts for more than 2 to 3 weeks, or is accompanied by more serious symptoms like a high fever, chest pain, shortness of breath, wheezing, or bloody mucous, it’s probably time to see a doctor.

Over 3 million cases of acute bronchitis are diagnosed annually. Acute bronchitis can occur any time of the year but is most common in the colder, winter months. It is most frequently seen in infants, younger children and seniors.

Risk factors for acute bronchitis include smoking, air pollution, dust or lung irritants, other lung diseases like lung cancer or emphysema, and some heart diseases.

Acute Bronchitis

Common health questions about acute bronchitis include:

  • What are the usual symptoms and methods of diagnosis for bronchitis?
  • What causes bronchitis?
  • Should bronchitis be treated with an antibiotic?
  • Is bronchitis contagious?
  • What is the difference between acute and chronic bronchitis?
  • Is there any way to prevent bronchitis?
  • For more questions and answers about bronchitis, join the Bronchitis Support Group.

What Are the Symptoms of Acute Bronchitis? How Is It Diagnosed?

The main symptoms of acute bronchitis are a cough, often with sputum, the mucus-like substance brought up from the lungs. The sputum may be clear, purulent (opaque or green), or occasionally contain blood. Usually you have had an ongoing cold or flu, as well, that may have started at least a week prior. Your cough has been present for a week or longer.

Other symptoms may include:

  • Wheezing
  • Chest pain, tightness
  • Shortness of breath
  • Sore throat
  • Nasal congestion
  • Mild Fever (not common)
  • Feeling tired

If your cough is accompanied by a high or prolonged fever, seek medical advice. A high fever may indicate a more serious bacterial infection, such as pneumonia, or a viral infection such as influenza. Older patients may present with a low-grade fever but still have pneumonia. It is important to have a doctor examine you for secondary bacterial pneumonia, which may require an antibiotic. If influenza is diagnosed within 48 hours of symptom onset, an antiviral treatment like oseltamivir (Tamiflu) or zanamivir (Relenza) may be recommended.


Your doctor will take a history of your symptoms, listen to your lungs, perform a physical examination, check your vital signs, and may order a chest x-ray or blood work to look for signs of infection.

Use the Symptom Checker to Make A More Informed Decision With Your Doctor

What Causes Acute Bronchitis?

Acute bronchitis is usually linked with a viral upper respiratory tract infection, such as a cold (rhinovirus). Other common viruses that can result in acute bronchitis include:

  • Respiratory syncytial virus (RSV)
  • Adenovirus
  • Coronavirus
  • Influenza viruses A and B
  • Parainfluenza

Should Acute Bronchitis Be Treated With An Antibiotic?

In general, antibiotics are not needed for acute bronchitis. Acute bronchitis is usually a lingering cough due to a viral cold or flu and is self-limiting. However, the cough is often the last symptom to go and may last for 3 to 6 weeks. Many studies have shown that antibiotic treatment is not beneficial for most cases of acute bronchitis, and may lead to unnecessary side effects and promote antibiotic resistance. However, in some patients, especially older patients or those with other severe or chronic diseases, the physician may elect to use antibiotic treatment.

  • Symptomatic Treatment
  • Nasal decongestants
  • Expectorants like guaifenesin
  • Mild pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)
  • Bronchodilators like inhaled ipratropium (Atrovent)

Symptomatic treatment will provide some symptom relief for coughs and colds associated with acute bronchitis and may be recommended by your physician. Rest, fluids, and a humidifier may also provide symptom relief.

Cough suppressants (dextromethorphan, codeine, benzonatate) have generally not been shown to be helpful. Inhaled beta-2 agonists like albuterol are generally not effective for acute bronchitis either, unless asthma is also present.

Is Bronchitis Contagious?

Because acute bronchitis is a complication of a viral infection, usually the common cold or the flu, acute bronchitis is considered contagious. These viruses spread from person to person. Patients with a weakened immune system or taking drugs that weaken the immune system are at greater risk for contracting acute bronchitis. However, patients who have asthma or chronic bronchitis and develop acute bronchitis as a complication of their primary condition are less likely to be contagious.

What Is the Difference Between Acute Bronchitis and Chronic Bronchitis?

Chronic bronchitis is a long-term condition. To be diagnosed with chronic bronchitis, you must have a cough with mucus on most days for at least 3 months. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD). Patients with chronic bronchitis can develop exacerbations of acute bronchitis.

Is There Any Way to Prevent Bronchitis?

Since acute bronchitis typically occurs as a complication of the common cold or flu, some general prevention measures may help to prevent complications.

  • Get vaccinated against the influenza (flu) virus every year in the early fall in the U.S. You may also consider vaccination against certain types of pneumonia as well as pertussis (whooping cough). Your pharmacist or doctor can help you determine if you are a candidate for these vaccines.
  • To reduce your risk of catching a viral infection, wash your hands frequently with soap and water and use alcohol-based hand sanitizers.
  • Avoid close contact with sick people.
  • Avoid touching your eyes, nose and mouth.
  • Don’t smoke, and stay away from secondhand smoke, dust, pollution, or chemicals.
  • What Should I Do If My Cough Does Not Clear Up?

Maybe you’ve already seen your doctor, but you now have new symptoms or your cough worsens or is still present after 3 weeks. If this is the case, contact your physician again. In acute bronchitis, coughing and airway sensitivity can persist up to 4 to 5 weeks, even after other symptoms have improved; however, you may need further evaluation.