[171] A number of different antibiotics may be used including amoxicillin, doxycycline and azithromycin; whether one is better than the others is unclear. [5] In the United States, in 2018, 9.3 million people were diagnosed with chronic bronchitis. [76], Spirometry measures the amount of airflow obstruction present and is generally carried out after the use of a bronchodilator, a medication to open up the airways. However, with continued excessive secretion, mucus clearance is impaired and when the airways become obstructed a cough becomes ineffective. [3] COPD treatments include smoking cessation, vaccinations, respiratory rehabilitation, and often inhaled bronchodilators and steroids. [80] Chronic bronchitis may occur with normal airflow and in this situation it is not classified as COPD. [5] In more than 90% of cases the cause is a viral infection. [102] Noninvasive ventilation may be used to support breathing. [62] LABAs such as salmeterol, formoterol, and indacaterol are often used as maintenance therapy. [35] The cough is often worse soon after awakening, and the sputum produced may have a yellow or green color and may be streaked with specks of blood. [44][45], Most cases of chronic bronchitis are caused by tobacco smoking. His findings were in association with his studies on chronic bronchitis among pottery workers. [62] In those without acidosis from respiratory failure, home care ("hospital at home") may be able to help avoid some admissions. [2] A 2018 review found the combination of LABA/LAMA may reduce COPD exacerbations and improve quality-of-life compared to long-acting bronchodilators alone. [160] In this situation, some (including NICE) recommend against its use. [2] Some developed countries have seen increased rates, some have remained stable and some have seen a decrease in COPD prevalence. [17], In those who smoke, stopping smoking is the only measure shown to slow down the worsening of COPD. [28][29] Estimates of the number of people who smoke and have chronic bronchitis who also have COPD is 60%. [6] Treatment of acute bronchitis typically involves rest, paracetamol (acetaminophen), and nonsteroidal anti-inflammatory drugs (NSAIDs) to help with the fever. [2] Which type of long-acting agent, long-acting muscarinic antagonist (LAMA) such as tiotropium or a long-acting beta agonist (LABA) is better is unclear, and trying each and continuing with the one that works best may be advisable. [3] While treatment can slow worsening, no cure is known. Causes, risk factors, and treatment options are … [78], Evidence for using spirometry among those without symptoms in an effort to diagnose the condition earlier is of uncertain effect, so currently is not recommended. [184] In the United States, COPD is estimated to be the third leading cause of death in 2011. [13] The term "emphysema" is also used for the abnormal presence of air or other gas within tissues. [132] All three together, LABA, LAMA, and ICS, have some evidence of benefits. The establishment of the diagnosis of chronic bron-chitis is often neglected when other overt spe-cific disease is present, although it is impor-tant to identify all diagnoses so that complete therapy can be instituted. Bronchitis can be acute or chronic.. [66] Exacerbations of the condition were also described at this time. Symptoms include coughing up sputum, wheezing, shortness of breath, and chest pain. [22] Early on it may just occur occasionally or may not result in sputum. Typically, these infections are rhinovirus, parainfluenza, or influenza. [153] Cough medicines are not recommended. Plastic bronchitis usually occurs in children. These include any previous diagnosis of asthma or atopy, a higher blood eosinophil count, substantial variation in FEV1 over time (at least 400 mL) and at least 20% diurnal variation in peak expiratory flow. [10][31][32] The term is still used clinically. [22] The amount of sputum produced can change over hours to days. [1][10] When this occurs together with decreased airflow it is known as chronic obstructive pulmonary disease (COPD). In the United States, 80 to 90% of cases of COPD are due to smoking. [citation needed] Individuals over 45 years of age, smokers, those that live or work in areas with high air pollution, and anybody with asthma all have a higher risk of developing chronic bronchitis. [121] The two major types are β2 agonists and anticholinergics; both exist in long-acting and short-acting forms. [181] In the United States approximately 6.3% of the adult population, totaling approximately 15 million people, have been diagnosed with COPD. 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