Antibiotics Commonly Used to Treat Bronchitis

The prescribing of antibiotics for bronchitis is not common. That's because most cases of acute bronchitis—the kind that develops rapidly—are caused by a virus. Antibiotics won't be effective in these cases, since they only work on bacterial infections.

Antibiotics for bronchitis are only considered if your healthcare provider suspects a bacterial infection is causing your bronchitis or you are at elevated risk for a bacterial infection after your bout with viral bronchitis. Pneumonia is one such example.

Read on to find out more about how to treat bronchitis and the medicines used.

Bronchitis Basics 

Acute bronchitis is characterized by infection of the bronchi, the tubes that lead to your lungs. When they get infected, the tubes swell up and start producing protective mucus that triggers coughing. Bacteria or a virus can cause this infection, thus bronchitis treatments vary based on the cause. They also vary based on the individual patient.

In the United States, researchers believe that viruses cause about 90% of cases of acute bronchitis. Viral bronchitis is caused by the same viruses that cause colds and flu, which practitioners can’t treat with antibiotics.

Symptoms of bronchitis can last around three weeks after an initial cold. They include: 

• A cough that keeps you up at night
• A sore chest from coughing
• A sore throat from coughing
• Lingering tiredness, headaches, and body aches 
• A low-grade fever

Most of the time, your bronchitis should resolve on its own. Get in touch with your healthcare provider if you have:

• A temperature above 100.4 degrees F
• Bloody mucus from too much coughing
• Wheezing and trouble breathing
• Symptoms that persist for longer than three weeks 
• Bronchitis that goes away and comes back

Types of Antibiotics for Bronchitis

Antibiotics should not be used as a first-line treatment for bronchitis. If your practitioner does decide to treat your cough with antibiotics, they’re likely to prescribe:

• Extended macrolides like Zithromax (azithromycin)
• Fluoroquinolones like Cipro (ciprofloxacin) and Levaquin (levofloxacin)
• Aminopenicillins like Principen (ampicillin), Moxatag (amoxicillin), and Hetacin (hetacillin)
• Cephalosporins

How Your Healthcare Provider Chooses

Your healthcare provider will only prescribe antibiotics for bronchitis if they think bacteria are causing your symptoms and you’re at high risk of the infection not resolving on its own. 

If a virus causes your bronchitis, they won’t give you antibiotics because the antibiotics wouldn’t do anything. If you’re young and generally healthy, they probably won’t prescribe anything either.

A Cochrane report last updated in 2017 found little evidence that antibiotics help acute bronchitis in healthy people, but recommended further study for patients that are elderly, frail, or have other conditions that may make bronchitis worse.

When considering treatment, your healthcare provider will look at:

• If you’ve had an allergic reaction to an antibiotic in the past
• Other health conditions, like autoimmune diseases, heart conditions, and lung conditions like asthma or chronic obstructive pulmonary disease (COPD)
• Your history with smoking or vaping
• The oxygen levels in your blood

If your practitioner decides to prescribe an antibiotic, the treatment they choose will be based on your medical history, personal details, symptoms, diagnosis, and test results.

Antibiotics for Cough From Other Causes

While it’s not likely that you’ll be prescribed antibiotics for bronchitis, it is possible that you’ll need antibiotics for an incessant cough caused by another bacteria.

An infection called whooping cough is caused by the bacteria Bordetella pertussis and can cause a lingering cough. Luckily, it’s prevented in most cases by the pertussis vaccine, which has reduced whooping cough infections drastically.

If you haven’t been vaccinated against whooping cough (or if your child is too young to get the vaccine), it’s possible a cough could be caused by the pertussis bacteria.

The symptoms of pertussis are very similar to those of bronchitis. They include initial cold-like symptoms, including:

• A sniffly, runny nose
• A low-grade fever
• A mild, occasional cough
• Unusual pauses in breathing (in babies)

In pertussis, especially in those who haven’t been vaccinated, these symptoms worsen and develop into unusual coughing fits with an accompanying high-pitched “whoop” sound. This usually happens one to two weeks after the initial infection.

These coughing fits can cause exhaustion and vomiting, and can last a long time—up to 10 weeks or more. (This infection is called the 100-day cough in China.)

Pertussis infections are treated with antibiotics, and early treatment is essential to ease symptoms and prevent the spread of the disease.

If you’ve got a weird-sounding cough, or develop a cough after a cold and know that you’ve been exposed to whooping cough or that it’s actively spreading in your community, you should call your healthcare provider. Note, however, that they may not want you to come into the office, because whooping cough is highly contagious.

Also, try to stay away from others, especially those too young to be vaccinated. Whooping cough is extremely dangerous to infants.

Antibiotics commonly prescribed to treat pertussis include:

• Zithromax (azithromycin)
• Biaxin (clarithromycin)
• Robimycin (erythromycin)

How Long You’ll Take Them

Whenever you’re prescribed antibiotics, you need to take the full course of drugs, anywhere from seven to 14 days. You need to continue taking them even if you start feeling better before the course is done.

If you stop taking the antibiotic before finishing every dose, the bacteria may come back stronger and resistant to the drug—meaning that type of antibiotic may no longer help your body fight off that infection.

What Happens If You Don’t

If you don’t take the antibiotics prescribed by your healthcare provider, your bronchitis may continue to get worse and may even turn into pneumonia.

Alternative Treatments

Whether you have bacterial or viral acute bronchitis, several other types of treatments, including natural remedies, may help soothe your symptoms:

• Make sure to get good rest and take care of yourself while you’re sick. 
• Drink plenty of fluids. 
• If you’re stuffy, try a humidifier, saline nasal spray, or breathe in steam from a bowl of hot water or a shower. 
• Honey (in hot water or straight) might help soothe a cough or sore throat, but never give honey to a child under 1 year of age.
• Popsicles, lozenges, and hard candies can help with a sore throat.
• Ask your healthcare provider if a cough medicine or mucus-busting over-the-counter medicine is appropriate. 
• Over-the-counter pain relievers may help with body aches and a sore throat or chest. Make sure to check with your practitioner about the best options and dosage for yourself or your child.

These kinds of treatments won’t take the place of antibiotics if you need them to beat acute bacterial bronchitis; they’ll just help soothe the symptoms. Further, the antibiotic will help your body fight off the bacteria causing the infection, but won’t help break up mucus or soothe night coughing.

Side Effects

Besides not being effective against the usual viral causes of bronchitis, the risk of side effects is another reason that antibiotics are not commonly used to treat bronchitis. The Cochrane report mentioned above found that patients given antibiotics were more likely to have side effects from them.

Common side effects of antibiotics used to treat bronchitis include:

• Rash 
• Nausea
• Diarrhea
• Allergic reaction to the antibiotics, including anaphylaxis, which is potentially deadly
• An antibiotic-resistant infection that needs to be treated with different antibiotics to rid your body of it completely
• An infection with the intestinal bacteria Clostridioides difficile (C. diff), which causes terrible diarrhea