infectious

Acute Bronchitis (Uncomplicated Adult)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 sources

Egyptian National Drug Formulary - Respiratory 2026 (ambroxol monograph) · Egyptian National Drug Formulary - Respiratory System 2026 (dextromethorphan monograph) · NICE Guideline NG138: Cough (acute) 2019 · UK eMC Paracetamol 500mg Tablets / Suspension SmPC (or DailyMed Acetaminophen Package Insert)

Verified against4 documents

Egyptian National Drug Formulary - Respiratory 2026 (ambroxol monograph)
Egyptian National Drug Formulary - Respiratory System 2026 (dextromethorphan monograph)
UK eMC Paracetamol 500mg Tablets / Suspension SmPC (or DailyMed Acetaminophen Package Insert)
Acute Bronchitis - disease-level clinical article (acute-bronchitis-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (7)

A productive cough with malaise, breathlessness, and wheeze are typical complaints, with the cough usually the dominant symptom [breathlessness · cough · malaise · wheeze]
Sputum is often clear or yellow but sometimes pus-like; purulent sputum alone doesn't mean a bacterial cause or need for antibiotics [pus · sputum]
The cough usually lasts 10 to 20 days, averaging around 18 days [cough]
Coughing fits with an inspiratory whoop or vomiting after coughing should raise concern for pertussis [cough · vomiting]
Cough lasting a week or more with lower respiratory symptoms points to bronchitis rather than a simple upper respiratory infection [cough]
About half of patients produce purulent sputum, and forceful coughing can cause self-limited chest wall muscle pain [cough · muscle pain · sputum]
A high fever is unusual in acute bronchitis and should prompt further workup if present [fever]

Signs — what you find (3)

Lung auscultation may reveal wheeze, and rhonchi that clear or improve with coughing [cough · wheeze]
Rales or egophony on exam should raise concern for pneumonia rather than bronchitis [crackles]
Mild tachycardia can accompany fever and dehydration from the viral illness [dehydration · fever · tachycardia]

Tests (10)

Diagnosis is clinical from history and lung exam; further testing usually isn't needed if vital signs are normal and there's no sign of pneumonia
Older patients over 75, or those with cognitive impairment, need a broader workup even with reassuring vitals
A chest x-ray helps tell pneumonia apart from bronchitis when infiltrates are seen
Chest x-ray is recommended when heart rate exceeds 100, respiratory rate over 24, oral temperature above 38 C, or egophony/fremitus is found
Complete blood count and a chemistry panel may be checked to work up a fever, and white count can be mildly elevated
Rapid influenza testing is useful in season for higher-risk patients like the elderly, young children, and pregnant women
Multiplex PCR of a nasal swab can pick up pertussis and atypical bacteria like Mycoplasma or Chlamydia pneumoniae in one test
Sputum gram stain and culture are usually discouraged since bacteria rarely cause the illness
Procalcitonin can help decide on antibiotics when the diagnosis is uncertain, and guided therapy has cut antibiotic use while improving survival
Spirometry can show transient airway hyperreactivity in about 40% of patients, with 17% of those showing FEV1 reversibility over 15%

If not this — what else fits (3)

Asthma exacerbation is commonly mistaken for acute bronchitis; about a third of these patients present with acute cough
Other mimics include sinusitis, bronchiolitis, COPD, reflux disease, viral pharyngitis, heart failure, pulmonary embolism, and pneumonia
A cough persisting beyond 3 weeks warrants considering other causes

SourceStatPearls "Acute Bronchitis" - disease-level clinical article

Presentation findings are traced to the source above.

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line

Dose source

Acute Bronchitis - disease-level clinical article (acute-bronchitis-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions

RED FLAG - The criteria for chest X-ray to exclude pneumonia are heart rate >100, respiratory rate >24, temperature >38°C, and egophony/fremitus.

DEXTROMETHORPHAN

add-on - not a substitute

Strength15 mg

Formoral.solid

Adult dose and duration

10-20 mg every 4-6 hours as needed for a dry cough (maximum 80 mg in 24 hours)

Paediatric dose

(Syrup is contraindicated under 6 years and tablets under 12 years. Child 6-11 years: 5 mL of syrup up to four times daily.)

Dose by age
6 to 11 years:	5 mL of the syrup up to four times daily. The syrup is contraindicated under 6 years and the tablets under 12 years.

Dose source

Egyptian National Drug Formulary - Respiratory System 2026 (dextromethorphan monograph)

Why

Centrally acting cough suppressant added for troublesome dry cough; it relieves the symptom only, does not treat the underlying viral infection, and should be avoided if the cough is still productive and clearing sputum.

Cautions

Do not suppress productive cough where clearance of sputum is necessary.
May cause mild somnolence or dizziness.
Contraindicated in patients taking monoamine oxidase inhibitors (MAOIs) or within 14 days of stopping such treatment.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
TUSSILAR 10 MG 20 TABS.? strength differs	KAHIRA	2.85 EGP (0.14/unit)
CODIPHAN 10MG/5ML SYRUP 120ML? strength differs? different route - not oral solid	EL NILE.	10.00 EGP

AMBROXOL

add-on - not a substitute

Strength30 mg

Formoral.solid

Adult dose and duration

Immediate release (tablet, syrup or solution): 60-120 mg/day in 2 to 3 divided doses. Extended-release capsule: 75 mg once daily

Paediatric dose

(Children 2-6 years: 7.5 mg three times daily. Children 6-12 years: 15 mg two to three times daily. Infants: the monograph gives 1.2-1.6 mg/kg without specifying per dose or per day, so the numeric fields are left null rather than guessed. Not for children under 2 years.)

Dose by age
2 to 6 years:	7.5 mg three times daily
6 to 12 years:	15 mg two to three times daily

Dose source

Egyptian National Drug Formulary - Respiratory 2026 (ambroxol monograph)

Why

19 live products, and one of the most-dispensed cough preparations in Egypt. The formulary's oral indication is acute and chronic respiratory tract disorders with pathologically thickened mucus and impaired mucus transport. Included so a search does not come back empty, with the evidence limitation stated in the cautions.

Cautions

Acute bronchitis is viral and self-limiting. A mucolytic does not shorten it, and antibiotics are not indicated - the honest treatment is reassurance that a post-viral cough lasts 2-3 weeks.
The evidence of benefit is modest and comes mainly from studies in chronic productive cough, not acute bronchitis.
Rare but serious skin reactions have been reported with ambroxol - Stevens-Johnson syndrome, erythema multiforme and acute generalised exanthematous pustulosis. Stop at the first rash.
The buccal spray and lozenges are local anaesthetics for sore throat - a different indication at a different dose from the oral mucolytic.
Do not combine with the dextromethorphan already listed in the same row - suppressing a cough while thinning the sputum works against itself.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
MUCOSOLVAN 30MG 20 TAB.	CID > SANOFI	14.00 EGP (0.70/unit)
MUCOSOLVAN 15MG/5ML SYRUP 100ML? strength differs? different route - not oral solid	CID > SANOFI	8.00 EGP
PULMOSOLVAN 15MG/5ML SYRUP 100ML? strength differs? different route - not oral solid	CID	8.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.