A number of different antibiotics may be used including amoxicillin, doxycycline and azithromycin; whether one is better than the others is unclear.  In the United States, in 2018, 9.3 million people were diagnosed with chronic bronchitis. , 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.  COPD treatments include smoking cessation, vaccinations, respiratory rehabilitation, and often inhaled bronchodilators and steroids.  Chronic bronchitis may occur with normal airflow and in this situation it is not classified as COPD.  In more than 90% of cases the cause is a viral infection.  Noninvasive ventilation may be used to support breathing.  LABAs such as salmeterol, formoterol, and indacaterol are often used as maintenance therapy.  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. , Most cases of chronic bronchitis are caused by tobacco smoking. His findings were in association with his studies on chronic bronchitis among pottery workers.  In those without acidosis from respiratory failure, home care ("hospital at home") may be able to help avoid some admissions.  A 2018 review found the combination of LABA/LAMA may reduce COPD exacerbations and improve quality-of-life compared to long-acting bronchodilators alone.  In this situation, some (including NICE) recommend against its use.  Some developed countries have seen increased rates, some have remained stable and some have seen a decrease in COPD prevalence. , In those who smoke, stopping smoking is the only measure shown to slow down the worsening of COPD.  Estimates of the number of people who smoke and have chronic bronchitis who also have COPD is 60%.  Treatment of acute bronchitis typically involves rest, paracetamol (acetaminophen), and nonsteroidal anti-inflammatory drugs (NSAIDs) to help with the fever.  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.  While treatment can slow worsening, no cure is known. Causes, risk factors, and treatment options are … , 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.  In the United States, COPD is estimated to be the third leading cause of death in 2011.  The term "emphysema" is also used for the abnormal presence of air or other gas within tissues.  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..  Exacerbations of the condition were also described at this time. Symptoms include coughing up sputum, wheezing, shortness of breath, and chest pain.  Early on it may just occur occasionally or may not result in sputum. Typically, these infections are rhinovirus, parainfluenza, or influenza.  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.  The term is still used clinically.  The amount of sputum produced can change over hours to days.  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