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Chest infections - adult - Management
When should I prescribe an antibiotic in a person with acute bronchitis?
- Antibiotics are not indicated in people who are otherwise well. Explain why antibiotics are not necessary, giving written information if necessary.
- Consider prescribing antibiotics for people who have a pre-existing condition that impairs their ability to deal with infection or is likely to deteriorate with acute bronchitis. This includes people:
- Who are over 75 years of age, with fever.
- With chronic obstructive pulmonary disease (COPD).
- With heart failure.
- Who are immunocompromised, including people with cancer or insulin dependant diabetes.
- A delayed antibiotic prescribing strategy for people with acute bronchitis can be considered where it is felt safe not to prescribe antibiotics immediately.
- Reassure the person that antibiotics are not needed immediately as they will make little difference to symptoms, and may have adverse effects.
- Advise the person to use the delayed prescription if symptoms do not settle or get significantly worse.
- Advise the person about the need for review if symptoms get significantly worse despite using the delayed prescription.
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