Acute Exacerbation of Chronic Bronchitis
2 medicines
An acute exacerbation of chronic bronchitis is a sudden worsening of chronic bronchitis symptoms, usually triggered by infection. When the cause is bacterial, it is treated with antibiotics such as cefuroxime or cefdinir.
Key facts
- Acute exacerbation of chronic bronchitis (AECB) is a sudden worsening in someone with chronic bronchitis, marked by increased cough, thicker or more discoloured sputum, and worsening breathlessness.
- Roughly half of all episodes are triggered by bacterial infection; the rest come from viral infections or environmental irritants such as smoke and air pollution.
- When sputum turns purulent or breathlessness clearly worsens, an antibiotic is typically needed. Cefuroxime and cefdinir, both antibiotics, are commonly used options.
- Seek urgent medical attention if breathing deteriorates rapidly, your lips or fingertips turn blue, or you can't speak in full sentences.
What's happening
Chronic bronchitis is a long-term inflammation of the airways that causes an ongoing productive cough, usually as part of chronic obstructive pulmonary disease (COPD). An acute exacerbation is a flare-up on top of that baseline: the airways become more inflamed and narrowed, mucus production rises, and breathing gets noticeably harder for days to weeks.
What drives an exacerbation
Most exacerbations are set off by a respiratory infection. Bacteria account for roughly half of all episodes, with species such as Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae most frequently implicated. Viral infections and environmental irritants, including smog and cigarette smoke, trigger most of the remainder. Cold, dry air and periods of heavy air pollution can tip a stable patient into an acute episode.
Antibiotic treatment
When sputum turns purulent or breathlessness noticeably worsens, an antibiotic is typically needed. Oral beta-lactams are the most commonly used class. Cefuroxime is a second-generation cephalosporin with reliable activity against the commonest AECB pathogens. Cefdinir, a third-generation cephalosporin, offers a similar spectrum with once- or twice-daily dosing. Which one is used depends on local resistance patterns and your prior history.
Alongside any antibiotic, short-acting bronchodilators, adequate hydration, and rest support recovery.
When to see a doctor
Seek urgent medical attention if your breathing deteriorates rapidly, your lips or fingertips turn blue, or you cannot speak in full sentences.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.