Coughing sucks! Nothing attracts more attention than a cough. It comes in so many flavors - wet, dry, green, yellow, hacking, tightness, wheezing, productive, barking, and so on.
source: https://flic.kr/p/AuurR
What exactly is bronchitis? Simply, inflammation of the bronchial airways. It can be caused by viruses, bacteria, allergies, asthma, environmental exposures, and more. Antibiotics are NOT always the best treatment for bronchitis. True, some folks swear by the trusty old "Z-pack" -- that 5 day course of antibiotics --- that seems, for some, to "knock it out".
In reality, antibiotics usually don't help bronchitis. Rather, your immune system generally does it's job to rid your body of the virus and/or inflammation.
So how do you know if it's a bacteria, virus, or something else? Sometimes it is tough to tell the difference. A lot can be gleaned from the history of your cough, the character of your cough, what makes it worse/better, and your medical history. You can enter all of your symptoms into your favorite internet search engine and perhaps get an idea. However, diagnosing and treating bronchitis is something that should probably be left to a physician. Especially if you are wondering whether or not you need a prescription.
Try this first:
*Drink plenty of fluids. That mucus that drains down the back of your throat and builds up in your chest is more likely to move up and out of your chest and sinuses when you are a hydrated. The less you drink, the more stubborn your phlegm gets. It becomes more like velcro stuck to your throat (thus the sore throat) and more likely to harbor nasty bacteria and worsen your condition. Water and/or warm salty solution (i.e. soup or tea) can go a long ways toward reducing your cough and helping you feel better.
* Sleep with a few pillows to prop your head up. This will keep the mucus from settling in the back of your throat and causing you to cough all night.
* Over-the-counter medications such as guaifenesin (e.g. Mucinex, Robitussin), plain or with the "DM" may be worth a try. These are essentially expectorants that work best when combined with plenty of water. Caution with diphenhydramine (Benadryl) or doxylamine (in Nyquil) products which may dry things up a little too well and lead to excessively dry/sticky phlegm like that mentioned above. Decongestants can also be drying but are ok to try for a short period of time (a few days) to help with daytime congestion and sinus/ear pressure. Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) will help with the fever, aches, and pains.
* Humidity. The warm steam and humidity from soups, teas, showers, and the like all lessen those sensitive airways with tend to be more reactive in cold and dry environments (i.e. winter time)
Try this second if you happen to have the following around:
* Albuterol (e.g. ProAir, Ventolin). If you happen to have asthma, chronic bronchitis, or COPD, then you likely have some albuterol around either in the handheld inhaler form or as a solution for the nebulizer. This bronchodilater helps with bronchospasm which is what often causes the cough of bronchitis. If you wheeze when you cough or breath out fast, you likely have bronchospasm and you would benefit from an inhaler. Your physician can prescribe an inhaler if needed.
* Prednisone. Ok, most doctors would say these should ONLY be taken as prescribed by your doctor. These steroids are pure anti-inflammatories, used for just about any inflammatory condition known to man. Usually a "burst" dose of 20-40 mg/d for 5-7 days will do wonders for your cough. Of course, prednisone does come with several precautions: elevates blood sugar (careful if you are diabetic), makes one moody or "amped up", may increase weight temporarily due to water retention, and they are not to be abruptly stopped if taking for more than 10-14 days (thus the 5-7 day burst). Often used second line, steroids can get a person with persistent cough and bronchitis over the hump.
If you have the following "RED FLAGS", contact your physician:
* Fever for more than 24 hours (over 100.3); older folks may just have chills, sweats, or rigors.
* Bloody sputum/phlegm
Bloody Streaked Sputum (photo credit: CirrusMED.com)
* Shortness of breath
* Inability to keep fluids down or excessive nausea/vomiting/diarrhea
The following are common symptoms along with bronchitis:
* Chest wall / rib pain with the cough -- likely strained chest wall muscles from coughing; usually sharp in nature. Chest pain with exertion that is pressure-like may indicate a more serious condition and would need to be evaluated.
* Clear or yellow sputum
What about GREEN or BROWN sputum?
Color of sputum doesn't necessarily correlate with bacterial, viral or other causes of bronchitis. However, if one has green or dark colored sputum, usually after a few days of coughing, with general malaise, +/-fever, +/- aches and generally feeling worse than the previous few days, this might indicate a secondary bacterial infection that may respond to antibiotics. This is by no means a stead and fast rule. Sputum or phlegm color and consistency is only one factor doctors use to determine how best to treat cough and bronchitis.
What can your online physician do for you?
Not sure what to do? Maybe you are experiencing some of the "red flags" described above or you are basically at your wits end? Rather than rushing to an urgent care, or leaving a message with your family doctor and hoping for a same-day appointment, why not message your online physician and/or set up an online consultation. Since your CirrusMED physician already knows your medical history, he or she can easily evaluate your case and if needed, prescribe the appropriate treatment.
Some things your personal Cirrus Medical Network (CirrusMED) physician can do include:
* evaluate your symptoms and determine what treatment would work best for you
* call in a prescription for antibiotics
* call in a prescription for cough syrup (non-narcotic)
* call in a prescription for prednisone
* call in a prescription for an albuterol inhaler
* follow-up with you to make sure you are improving
* document your care in a secure cloud-based medical record
All of this can be done from the convenience of your home. All you need is an internet connection. If you are on the road for the holidays or can't miss work, your CirrusMED physician will work with you so you can save time and money with "Your doctor. Online".
Will ibuprofen help decrease bronchial irritation of asthma.
Hello,
Ibuprofen is an NSAID anti-inflammatory. Some people with asthma are sensitive to NSAIDs and/or Aspirin, possibly worsening their condition. While most asthmatics would probably do fine taking ibuprofen, it is generally advised to take an alternative medicine for pain or bronchial inflammation– such as inhaled or oral steroids.
Have bronchitis and been on antibiotics for 4 days with little relief using a neti pot drinking Gatorade very tired missed 3 days of work will a steroid help?
Unfortunately we cannot provide specific medical advice (especially in a public forum), without a consultation. CirrusMED physicians are able to address your concerns and order MRI’s. Please check out our membership options. Thank you!
Last fall, coughing started with excessive mucus especially at night when trying to sleep. My Dr. Tried everything that would treat allergies and asthma. Nothing worked. Finally he put me on prednisone for 2 weeks. It did the trick. Unfortunately the symptoms are returning. Dont want to go back on prednisone again
Is there anything out there that I can get over the counter that would be a second best to prednisone?
I think this lasting cough, after 2 rounds of antibiotics and prednisone might be Pertussis….now what??? I’ve also finished 8iz of cough med with codeine and am using a steroidinhaler..,no improvement. I feel ok between coughing fits tho.
Unfortunately we cannot provide specific medical advice (especially in a public forum), without a consultation. CirrusMED physicians are able to address your concerns and order MRI’s. Please check out our membership options. Thank you!
Hi doctor , my husband Yuri is 1 70 , on for high blood medication, had cronic sinus,65 day ago he started fever 100.3 with coughing ; fever was gone after taking Talenol a few times time, now he has wet cough, clear mucus, on Musinex and Delsyn. Loosing voice, don’t want Z PACK
Unfortunately we cannot provide specific medical advice (especially in a public forum), without a consultation. CirrusMED physicians are able to address your concerns and order MRI’s. Please check out our membership options. Thank you!
Not 65 , 5 days
How do you know if yellow mucus is an infection or just bronchitis
Mucus/phlegm color is notoriously not a good indicator of whether one’s bronchitis is inflammatory, bacterial, or viral. Yet, doctors often ask about “colored sputum”..perhaps to help “paint the picture”.
I started taking prednisone yesterday morning by the evening nose is all stuffed up and I can’t breath out of my nose at all should I continue this prescription or stop taking it
Unfortunately we cannot provide specific medical advice (especially in a public forum), without a consultation. CirrusMED physicians are able to address your concerns and order MRI’s. Please check out our membership options. Thank you!
Will medrol pack decrease inflammation causing wheezing associated with acute bronchitis
Unfortunately we cannot provide specific medical advice (especially in a public forum), without a consultation. That being said, yes, steroids will reduce inflammation associated with bronchitis. NSAIDs, are not quite as effective, nor are they typically used for bronchitis inflammation. CirrusMED physicians are able to address your concerns. Please check out our membership options. Thank you!
Follow up re medrol pack for wheezing or will NSAIDs work for wheezing associated with acute bronchitis
Hi There! I am currently battling bacterial bronchitis (as determined by my family doctor). I have 2 days left of prednisone and a z-pak. I was sick for about 12 days before I started getting a low grade fever and feeling very tired, the coughing got worse etc. so that is when I decided to go to the doctor (on Monday, so 3 days ago). I am starting to feel much better but my cough just will not stop. In addition to the meds above I have been using cough syrup (an OTC Robitussen which is just a suppressant as well as a prescribed expectorant with Codine in it). The otc cough syrup works better than the prescription at easing my cough but it is still almost unbearable. For 2 nights in a row I have had a 2 hour coughing fit where i start throwing up. I have been steaming, using cough drops…. anything that I can think of to try to ease the cough to no avail. Is there anything else I can try or ask my doctor to prescribe for me? I am willing to try anything at this point.
Unfortunately we cannot provide specific medical advice (especially in a public forum), without a consultation. CirrusMED physicians are able to address your concerns. Please check out our membership options. Thank you!
I gave had many drs tell me how bad prednisone is for me. I have had 3 short courses last year and 1 this year. One dr would NOT prescribe, told me it would kill me..I have chronic cough. Would lije to kniw how bad for me I am 70 years old..no asthma or copd
Dorthe,
Unfortunately we cannot provide specific medical advice (especially in a public forum), without a consultation. CirrusMED physicians are able to address your concerns. Please check out our membership options. Thank you!
Wow. Admin most always has the same response. Not much help.
For clinical inquiries, we cannot provide medical advice via a public blog forum, due to privacy laws. For those seeking specific clinical advice, we recommend establishing care with one of our doctors.
Hello I went to urgent care on March 25th an was diagnosed with Bronchitis I was giving a anti biotic an steroid an a cough medicine called “Hydrocod/Bit/Homat Syrup I took the all the meds an my cough did improve some but I do still have a cough An unlike the last week for the last 24 hours everytime I cough my ribs an chest hurt how long does it usually take for this to go away I had it for about a good 2 weeks now?
Andre, unfortunately we cannot provide specific medical advice (especially in a public forum), without a consultation. CirrusMED physicians are able to address your concern. Please check out our membership options. Thank you!
Went to a walk in doctor’s office bad cough phlegm told me my lung seemed clear what i fell to mention is that i breath in a lot of pollen when blowing off the roof she prescribed prednisone benzonatate fluticasone she wanted me to use these for a few days before I used the z pack she said if it didn’t get better then to use the z pack but I did use the Benzonatate for day 2 at a 100 mg and felt like the cough got worse so I took my 1st dose of the z pack tonight can I take the benzonatate and the z pack together I’m not really crazy about using the prednisone 20mg I’m a 57 year old male in good shape but I do take Lisinopril 2.5 mg
Ronald, unfortunately we cannot provide specific medical advice (especially in a public forum), without a consultation. CirrusMED physicians are able to address your concern. Check out our membership options.
Is there a prescription steroid inhaler that helps with coughs?
Inhaled corticosteroids such as Qvar, Pulmicort, Flovent and others are generally indicated for long term management of inflammatory lung conditions like asthma and COPD. Sometimes they are used to treat a chronic cough associated with these and other inflammatory lung conditions. Acute, short term use of a steroid inhalers may or may not help a cough.
Thanks,
The information provided was helpful ….
According to me best option is eating honey with black pepper, really worked for me. Thanks for sharing
Good to know! thanks for your input.
This is my 4th day of severe bronchitis. I have a nebulizer & albuterol meds & have been using that. DR called in zpak. Now I have coughed so much, I am nauseated. Went back to hard green. did not take fever but suspect high. I have gone thru 4 boxes of Kleenex. Also taking mucinex. I am getting worried. No better.
Unfortunately we cannot provide specific medical advice (especially in a public forum), without a consultation. CirrusMED physicians are able to address your concerns and prescribe medications if deemed necessary. Please check out our membership options. Thank you!
Is it ok to use Flovent with prednisone? . One is local vs systemic. I was prescribed to the both. Prednisone should take care of any inflammation..
You are correct. Flovent is “topical”/inhaled and prednisone is systemic.
Unfortunately we cannot provide specific medical advice (especially in a public forum), without a consultation. CirrusMED physicians are able to address your concerns. Please check out our membership options. Thank you!
Can i use .5mg of prednisone along with delsum 12 hr cough syrup
Unfortunately we cannot provide specific medical advice (especially in a public forum), without a consultation. CirrusMED physicians are able to address your concerns. Please check out our membership options. Thank you!
You need to take down your recommendation for steroids now that studies have shown conclusively that steroids do not help with strength or duration of symptoms with bronchitis.
Also, all people commenting here should be aware that the majority of bronchitis cases are viral and CANNOT be helped with antibiotics. Doctors prescribe antibiotics, anyway, because patients demand the doctor do something. Don’t be that kind of patient.
JHS makes an excellent point. Steroids, antibiotics and albuterol should be used judiciously as the majority of bronchitis cases are self-resolving viral infections. When in doubt, seek advice from your physician (especially if you have a history of chronic bronchitis, emphysema ,COPD, asthma or previous pneumonia).
Actually, maybe that’s what studies show but that’s not what happened to me. In the past 6 months I have been hit with acute asthmatic bronchitis. Maybe that’s not the type of bronchitis you area referring to but it’s because I had a large wheezing component to my bronchitis and literally could barely breathe. Anyway the first three times I had it I REFUSED to take prednisone because of things I heard about it. The first time I was sick for 6 weeks and was miserable. Anyway, I’ve had it again for 2.5 weeks–pretty bad. I finally went to the doctor and got a script and after ONE DAY my symptoms have drastically reduced. Before this I was taking mucinex and delays daily and seeping with almost 3 pillows every night. Last night I was finally able to sleep with one pillow and I haven’t had to take any OTC cold medicines today. This is after one day!! So instead of telling people to stay away, maybe you should let them make up their own minds bc this is absolutely helping me. I’m not giving medical advice here, I’m just saying what worked for ME. Once I get better my doc wants me to get the flu shot then a little while after, he wants me to get the pneumonia shot since I’m so susceptible and I definitely don’t want to go through this again!!
hi L, I’m with you on the idea of prednisone as a last resort but I’m 15 days into a wicked cough that nothing has helped. I’m pleased to read that the prednisone has given you relief. Do you mind if I ask what dose you are on?
I’ve had Bronchitis for a little over a week now. I rarely get sick. Went to a cheesy local emergency clinic. I was seen by a doctor for a hot 20 seconds and prescribed a steroid, along with a few other prescriptions I haven’t picked up yet. It’s only been a few hours, but I feel 100% better. I’m not a doctor, but now I’m not a patient either.
Glad you’re feeling better!
Every time I’ve had bronchitis for more than three weeks, I’ve taken a Z-Pack and “magically” felt better after 2-3 days. All this negative press about anti-biotics is hyper-vigilant cow waste. I don’t get sick often, about once every 4-5 years, but when I do, it hits me pretty hard. It seems every common cold now turns into bronchitis for me and my family. The medical community needs to stop all this paranoia about anti-biotics and really study the cold/flu patterns, symptoms, and relief protocols. Oh, by the way, I’ve never had flu shot and don’t seem to suffer from the flu. The rest of my family gets the flu shot and seems to get sick way more often then I do. Does modern medicine really know what it’s doing when it comes to the cold and flu? I doubt it.