Hopp til hovedinnhold

Bronkitt, akutt

Sist revidert:
Sist revidert av:
Definisjon:
Akutt bronkitt er en nedre luftveisinfeksjon med inflammasjon i slimhinnen i bronkiene, uten tegn på lungebetennelse
Forekomst:
Insidens er funnet å være ca. 4% blant voksne over 16 år
Symptomer:
Tørrhoste, slimhoste, feberfølelse, varighet 1-4 uker
Funn:
Ved auskultasjon ofte pipelyder eller inspiratoriske knatrelyder, men fremmedlyder påvises ikke alltid. Ev. lavgradig feber. God allmenntilstand
Diagnostikk:
Tilleggsundersøkelser er vanligvis ikke påkrevd, ev. CRP, nasofarynksprøve
Behandling:
Akutt bronkitt er i de fleste tilfeller selvbegrensende
  1. Hueston WJ. Acute bronchitis. BMJ Best Practice. Last updated 13.06.2018. bestpractice.bmj.com  
  2. Kinkade S, Long NA. Acute bronchitis. Am Fam Physician 2016; 94(7): 560-5. pmid:27929206 PubMed  
  3. Harris AM, Hicks LA, Qaseem A, High Value Care Task Force of the American College of Physicians and for the Centers for Disease Control and Prevention. Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med 2016; 164:425. Annals of Internal Medicine  
  4. Ieven M, Coenen S, Loens K et al. GRACE consortium. Aetiology of lower respiratory tract infection in adults in primary care: a prospective study in 11 European countries. Clin Microbiol Infect. 2018 Nov;24(11):1158-1163. Epub 2018 Feb 12. PMID: 29447989 PubMed  
  5. Clark TW, Medina MJ, Batham S, Curran MD, Parmar S, Nicholson KG. Adults hospitalised with acute respiratory illness rarely have detectable bacteria in the absence of COPD or pneumonia; viral infection predominates in a large prospective UK sample. J Infect. 2014;69(5):507–515.
  6. Helsedirektoratet (2021). Nasjonal faglig retningslinje for antibiotika i primærhelsetjenesten nettdokument. Oslo: Helsedirektoratet (sist faglig oppdatert 16. november 2021, lest 16. november 2021).
  7. Jary H, Simpson H, Havens D, et al. Household air pollution and acute lower respiratory infections in adults: a systematic review. PLoS One. 2016 Dec 1;11(12):e0167656. Pmid: 27907205 PubMed  
  8. Macfarlane J, Holmes W, Gard P, et al. Reducing antibiotic use for acute bronchitis in primary care: blinded, randomised controlled trial of patient information leaflet. BMJ 2002; 324: 1-6. PubMed  
  9. van Vugt SF, Verheij TJ, de Jong PA, et al.; GRACE Project Group. Diagnosing pneumonia in patients with acute cough: clinical judgment compared to chest radiography. Eur Respir J. 2013;42(4):1076–1082. PMID: 23349450 PubMed  
  10. Little P, Rumsby K, Kelly J, et al. Information leaflet and antibiotic prescribing strategies for acute lower respiratory tract infection. A randomized controlled trial. JAMA 2005; 293: 3029-35. Journal of the American Medical Association  
  11. Little P, Francis NA, Stuart B, et al. Antibiotics for lower respiratory tract infection in children presenting in primary care in England (ARTIC PC): a double-blind, randomised, placebo-controlled trial. Lancet 2021. pmid:34562391 PubMed  
  12. Smith SM, Fahey T, Smucny J, et al. Antibiotics for acute bronchitis. Cochrane Database Syst Rev. 2017;(6):CD000245. Cochrane (DOI)  
  13. Smith SM, Schroeder K, Fahey T. Over the counter medications for acute cough in children and adults in ambulatory settings.Cochrane Database Syst Rev. 2012;8:CD001831. PMID:22895922 PubMed  
  14. Becker LA, Hom J, Villasis-Keever M, et al. Beta2-agonists for acute cough or a clinical diagnosis of acute bronchitis. Cochrane Database Syst Rev. 2015;9:CD001726. DOI: 10.1002/14651858.CD001726.pub5 DOI  
  15. Llor C, Moragas A, Bayona C, et al. Efficacy of anti-inflammatory or antibiotic treatment in patients with non-complicated acute bronchitis and discoloured sputum: randomized placebo controlled trial. BMJ 2013; 347: f5762 BMJ (DOI)  
  16. National Institute for Health and Care Excellence (NICE). Respiratory tract infections (self-limiting): prescribing antibiotics. Clinical guideline [CG69] Published date: July 2008. Siden besøkt 01.11.2018. www.nice.org.uk  
  17. Norsk barnelegeforening. Gjør kloke valg. Siden besøkt 26.02.2021. www.legeforeningen.no  
  18. Bolser DC. Cough Suppressant and Pharmacologic Protussive Therapy: ACCP Evidence-Based Clinical Practice Guidelines. Chest 2006; 129: 238S-249S. doi:10.1378/chest.129.1_suppl.238S
  19. Skrede B. Antitussiva – opioider. Norsk legemiddelhåndbok. Sist endret 03.04.2018.
  20. Paul IM, Beiler J, McMonagle A, Shaffer ML, Duda L, Berlin CM Jr. Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch Pediatr Adolesc Med 2007; 161: 1140-6 PubMed  
  21. Oduwole O, Meremikwu MM, Oyo-Ita A, et al. Honey for acute cough in children. Cochrane Database Syst Rev. 2014 ;12:CD007094. PMID: 25536086 PubMed  
  • Peter Jost, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Hasse Melbye, spesialist i allmennmedisin, førsteamanuensis ved institutt for samfunnsmedisin, Universitetet i Tromsø
  • Leif Bjermer, professor i lungesykdommer, Norges teknisk-naturvitenskapelige universitet, Trondheim
  • Dag Berild, overlege, Medisinsk klinikk, Aker Sykehus