Rationale:
There is no clinically meaningful evidence supporting the use of antibiotics for acute bronchitis. Atypical pneumonia is often suspected in cases of viral bronchitis, as both conditions can cause a prolonged cough (2-4 weeks). This likely contributes to the unnecessary prescription of macrolides and doxycycline for viral bronchitis. Antibiotic treatment should only be considered in patients who test positive for Mycoplasma pneumoniae or Chlamydia pneumoniae if pneumonia is suspected.
References:
- Kinkade S, Long NA. Acute bronchitis. Am Fam Physician. 2016; 94(7): 560-565.
- Helsedirektoratet. Atypisk pneumoni. Oslo: Helsedirektoratet (siste faglige endring 27. juni 2024, lest 25. april 2025). Tilgjengelig fra https://www.helsedirektoratet.no/retningslinjer/antibiotika-i-primaerhelsetjenesten/infeksjoner-i-nedre-luftveier/atypisk-pneumoni
- Hueston, JW. BMJ Best Practice. Acute bronchitis. https://bestpractice.bmj.com/ (Sist oppdatert: 13. mai 2022).
- Smith SM, Fahey T, Smucny J, Becker LA. Antibiotics for acute bronchitis. Cochrane Database of Systematic Reviews 2017, Issue 6. Art. No.: CD000245.