# Acute Bronchitis (Uncomplicated Adult) - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - 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) ## Treatment metadata - Referral & safety-netting (no drug therapy) - Dextromethorphan — 15 mg — oral.solid - Ambroxol — 30 mg — oral.solid ## Complete treatment card ```text ACUTE BRONCHITIS (UNCOMPLICATED ADULT) 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) Review status: REVIEWED against 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) (2026-08) 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 Source StatPearls "Acute Bronchitis" - disease-level clinical article Status traced to the source above 1. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult 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. Caution RED FLAG - The criteria for chest X-ray to exclude pneumonia are heart rate >100, respiratory rate >24, temperature >38°C, and egophony/fremitus. 2. DEXTROMETHORPHAN [add-on - not a substitute] Adult 10-20 mg every 4-6 hours as needed for a dry cough (maximum 80 mg in 24 hours) Peds 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. (Syrup is contraindicated under 6 years and tablets under 12 years. Child 6-11 years: 5 mL of syrup up to four times daily.) 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. Caution 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. Egypt TUSSILAR 10 MG 20 TABS. KAHIRA 2.85 EGP (0.14/unit) -> ? strength differs CODIPHAN 10MG/5ML SYRUP 120ML EL NILE. 10.00 EGP -> ? strength differs, ? different route - not oral solid 3. AMBROXOL [add-on - not a substitute] Adult Immediate release (tablet, syrup or solution): 60-120 mg/day in 2 to 3 divided doses. Extended-release capsule: 75 mg once daily Peds 2 to 6 years: 7.5 mg three times daily 6 to 12 years: 15 mg two to three times daily (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.) 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. Caution 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. Egypt MUCOSOLVAN 30MG 20 TAB. CID > SANOFI 14.00 EGP (0.70/unit) MUCOSOLVAN 15MG/5ML SYRUP 100ML CID > SANOFI 8.00 EGP -> ? strength differs, ? different route - not oral solid PULMOSOLVAN 15MG/5ML SYRUP 100ML CID 8.00 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)