Health Library Antibiotics for Acute BronchitisFrom Healthwise

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

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.

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.

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.)

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.

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

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. Wark P (2005). Acute bronchitis, search date March 2006. Online version of Clinical Evidence (14): 1–10.

3. Fahey T, et al. (2006). Antibiotics for acute bronchitis. Cochrane Database of Systematic Reviews (1). Oxford: Update Software.

4. 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.

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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