bronchitis%20-%20chronic%20in%20acute%20exacerbation
BRONCHITIS - CHRONIC IN ACUTE EXACERBATION
Treatment Guideline Chart

Chronic bronchitis is an infection of the trachea and bronchi for at least three consecutive months for more than two consecutive years.

The patient experiences symptoms of increase in dyspnea, sputum volume and sputum purulence over baseline on most days.

Diagnosis is basically based on clinical presentation.

Bronchitis%20-%20chronic%20in%20acute%20exacerbation Patient Education

Patient Education

  • Educate patient about the nature of the chronic bronchitis (the progressive nature and its potential impact on future lifestyle and function)
  • Review with the patient the signs of onset of infection (eg increased purulence, viscosity or volume of secretions) that should be treated early
  • Discuss measures that may limit the spread of viral infections (eg hand washing)
  • Encourage patients to exercise regularly
    • Although not accompanied by measurable improvement in lung function, it will increase exercise tolerance and improve the patient’s sense of well-being

Lifestyle Modification

Smoking Cessation

  • A discussion of smoking behavior and the setting of a specific cessation date should be part of every physician-patient encounter
    • Cigarette smoking is a predominant cause of chronic bronchitis
  • Patients presenting with AECB should be encouraged to stop smoking since it is the most effective way to reduce the risk of future morbidity from chronic bronchitis
    • Nicotine replacement and pharmacotherapy can increase long-term smoking abstinence rates
  • It can lead to dramatic symptomatic benefits for patients with chronic bronchitis eg stopping cough in 94-100%; when coughing stops, it can occur in as quickly as 4 weeks in 54% of patients

Reduction/Elimination of Irritants

  • Reduction or elimination of any source of irritants that may worsen lower airway inflammation
    • Includes environmental pollutants (eg dust, pollutants and second-hand smoke) and occupational irritants
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