Acute and chronic bronchitis. A practical management strategy.

Bronchitis is a common diagnosis in the primary care physician's office, especially during winter. Acute bronchitis is usually caused by viruses but a number of other pathogens may also be responsible. Therapy for acute bronchitis is generally supportive. Chronic bronchitis, characterized by prolonged sputum production, is most often caused by cigarette smoking, which decreases mucociliary transport velocity. This and other pathophysiologic effects of smoking can lead to exacerbations of the disease that may necessitate antimicrobial therapy. Antimicrobial agents and vaccines may have both prophylactic and therapeutic roles in the management of chronic bronchitis.