The Post-Antibiotic Era: Bronchitis

Dr. John Overholt • November 21, 2018

Appropriate Antibiotic Use: Part II


Part II of the when-not-to-use-antibiotics post deals with another common ailment: Bronchitis. We’ll be talking about acute bronchitis, not chronic bronchitis due to long-term smoking, which is a different animal altogether.



The term bronchitis is fairly non-specific. It simply means inflammation of the bronchial tubes or airways. This inflammation can occur for several different reasons, most commonly viruses or irritants, but rarely from bacteria. Viruses that cause bronchitis include influenza, parainfluinza, adenovirus and respiratory syncitial virus (RSV). Non-infectious causes of bronchitis include pollutants, chemicals, second-hand cigarette smoke and the like.



The hallmark of bronchitis is a cough, with or without mucus production. Depending on the cause, there may be fever, aches, headache and sore throat as well. The acute symptoms typically last less than two weeks, but the cough may linger for several weeks after. You should call your healthcare provider for high fever, thick or bloody mucus, or trouble breathing, but otherwise seek simple symptomatic treatment. Lots of great ideas are on this CDC web page .

Treating bronchitis with antibiotics simply adds to the cost, exposes people to the potential for adverse reactions, and adds to the growing rotes of antibiotic resistance.

Note that I did not mention antibiotics as a treatment. Since the vast majority of acute bronchitis is viral-or irritant-induced, antibiotics will not improve symptoms or shorten the duration of illness. (Anti-viral treatments for influenza can help if started early). Treating bronchitis with antibiotics simply adds to the cost, exposes people to the potential for adverse reactions, and adds to the growing rates of antibiotic resistance.

The one exception is pertussis, aka whooping cough. It is bacterial and responds to certain antibiotics. It also has an excellent vaccine that you and your children should all be up-to-date on. It had virtually disappeared from the U.S., but recent drops in vaccination rates and changes in vaccine composition have led to its reemergence. It causes a very characteristic, severe cough that can last for months, hence its old name, the 100-day cough.

So what can you do to prevent bronchitis? Avoid smoking and second-hand smoke for you and your kids, practice good hand hygiene, and stay current on your vaccinations, including pertussis and the yearly influenza vaccination.

I’ve borrowed liberally from the CDC website in writing this post. They have a ton of great information for the interested reader. I highly recommend it.

You might also like

Celebrate Summer Safely With Asthma

By Dr. Phil Jones • July 4, 2026
Summer is in full swing! Learn why some seasonal activities can cause flare-ups and how you can protect your lungs while still enjoying the festivities.
Mailbox

Mail-in Allergy Testing

By Dr. Nicholas Cline • May 27, 2026
If you spend any time browsing the internet or social media, you’ve likely seen advertisements for mail-in allergy kits. They promise to test for hundreds of food intolerances and environmental sensitivities using just a few strands of your hair or a quick saliva swab. It sounds incredibly convenient, painless, and comprehensive. But if it sounds like a gimmick, it probably is. While these mail-in tests are heavily marketed, they often lack scientific backing and can leave patients feeling more confused than comforted. The Science of Allergy Testing. What Are We Looking For? To understand why hair and saliva tests don't work, we have to look at how the immune system reacts to allergens. When you have a true allergy, your body produces a very specific type of antibody called IgE (Immunoglobulin E) . These antibodies bind to mast cells (allergy cells), which are on high alert to protect you from perceived invaders like pollen, dust mites, or specific food proteins. The fundamental flaw with mail-in hair and saliva kits comes down to basic biology: Wrong Locations: Mast cells and IgE antibodies are not traditionally found in your hair follicles or saliva. Unreliable Results: Because these testing methods are looking in the wrong place, they are highly unstandardized and unvalidated. You are highly likely to get a flood of false positives or false negatives that are impossible to interpret accurately. What the Experts Say: Major medical organizations strongly advise against these methods. The National Institute of Allergy and Infectious Diseases (NIAID) explicitly recommends against using hair analysis for food allergy evaluations due to a lack of diagnostic value. Furthermore, the American Academy of Allergy, Asthma & Immunology (AAAAI) and the American College of Allergy, Asthma & Immunology (ACAAI) have issued strong practice guidelines stating that hair analysis should not be used to evaluate food allergies. The Big Misconception: IgE vs. IgG Many mail-in companies charge anywhere from $150 to upwards of $600 for "sensitivity" panels. When patients produce these multi-page reports, the testing is almost always checking for IgG (Immunoglobulin G) antibodies, not IgE. There is a massive difference between the two:

It's Not The Spring Flowers

By Dr. Nicholas Cline • May 11, 2026
The Science Behind Spring Sneezes