Antibiotics for acute bronchitis

Examples

Generic Name Brand Name
amoxicillin Amoxil, 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 doctor 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

  • Antibiotics reduce coughing slightly, but most people who have bronchitis improve without antibiotics.
  • In people who also have symptoms of a common cold but have no signs of pneumonia, antibiotics generally are not effective.

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 medicines may increase their risk of sudden cardiac death.3 The study showed that the risk of sudden cardiac death is greater when erythromycin is taken with some medicines that inhibit certain liver enzymes—such as certain calcium channel blockers, certain antifungal medicines, and some antidepressants—than when these medicines 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 doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Although smokers with acute bronchitis receive antibiotics more than nonsmokers, antibiotics are no more effective in smokers than in nonsmokers.4

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.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Gonzales RG, et al. (2001). Principles of appropriate antibiotic use for treatment of uncomplicated acute bronchitis: Background. Annals of Internal Medicine, 134(6): 521–529.
  2. Fahey T, et al. (2004). Antibiotics for acute bronchitis. Cochrane Database of Systematic Reviews (4). Oxford: Update Software.
  3. Ray WA, et al. (2004). Oral erythromycin and the risk of sudden death from cardiac causes. New England Journal of Medicine, 351(11): 1089–1096.
  4. Wark P (2008). Bronchitis (acute), search date July 2006. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.

Last Updated: July 23, 2008

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