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    Suggest medication for chronic bronchitis

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Posted on Fri, 3 Jun 2016 in Lung and Chest disorders
Question: I have chronic bronchitis and have had most of my life. I cannot tolerate zpak any longer and I was given Ceferoxine then Cipro and have been extremely nauseated or diarrhea. Is there anything else safe that will not make me nauseous My doctor said to just stop all antibiotic he prescribed but the infection and coughing is pretty bad
doctor
Answered by Dr. Panagiotis Zografakis 38 minutes later
Brief Answer:
a tetracycline perhaps

Detailed Answer:
Hello,

you seem to have problems with almost every class of antibiotic that acts on chronic bronchitis patients! Tetracyclines like doxycycline are sometimes effective in respiratory tract infections, although their efficacy may depend on prior antibiotic exposure. Patients with long standing pulmonary disease may develop resistant strains of pathogens. In such cases only the quinolones (like ciprofloxacin, moxifloxacin or levofloxacin) usually provide a more reliable way to treat as an outpatient. If the patient does not respond adequately to outpatient treatment then more potent antibiotics can be used in the hospital.

There is no way to predict side effects like nausea or diarrhea. For nausea, using prokinetic drugs like domperidone or metoclopramide might help with the symptom. In case of diarrhea the antibiotic has to be stopped usually.

Doxycylince belongs to another class of antibiotics and may sometimes be effective. It's a broad spectrum antibiotic. If you have serious problems with any other antibiotics, you can give it a try.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis 21 minutes later
Is there any way to rid viral bronchitis withot antibiotic. I have been nausea for days and cannot take anymore. I have been on domperidone for years due to Gastroparesis after chemo. I am at my wits end. Thank you
doctor
Answered by Dr. Panagiotis Zografakis 5 minutes later
Brief Answer:
viral bronchitis does not require antibiotic unless it's influenza

Detailed Answer:
Viral bronchitis cannot be cured with antibiotics. Only patients with influenza may improve with antivirals. The commonly involved viruses in respiratory infections, using antibiotics may only cause side effects without any benefit.

If your doctor has documented the viral etiology then no antibiotic should be used (with the exception of influenza). An indirect way to document it is to check the white blood cells count and an inflammatory marker like CRP or PCT (procalcitonin).

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis 4 minutes later
What does it take to get rid of this if not antibiotics. Not sure if it's viral or bacterial
doctor
Answered by Dr. Panagiotis Zografakis 5 minutes later
Brief Answer:
the antibiotics are a big part of the treatment

Detailed Answer:
If there is uncertainty over the diagnosis (whether it's viral or bacterial) then antibiotics may be required. Other measures include inhaled drugs like beta-agonists, corticosteroids and muscarinic antagonists. Finally the phlegm has to be managed. Mucolytics may help to expectorate more and help clear the infection.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3691 Questions

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