A chest X-ray is usually unnecessary in uncomplicated cases of acute bronchitis. It is definitely indicated when patients do not improve after 2 to 4 days of observation, develop fever, or hemoptysis whether or not they received empiric antibiotic treatment. Bacteria least common cause of initial infection. Acute COPD exacerbations are usually self-limited, caused most commonly by viruses followed by bacteria, then Mycoplasma pneumoniae or Chlamydia pneumoniae. The treatment of acute bronchitis is mainly supportive.
Patient education is extremely important.
The use of antibiotics is very controversial. Clinical studies are equivocal as to the efficacy of antibiotics. Any decision to treat with antibiotics should be based on sound clinical judgement. Antibiotics should attack the probable pathogens causing acute bronchitis, minimize drug side effects, and maximize patient compliance. Strangely, tetracyclines have not been shown to be better than placebo in clinical trials.