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Acute Exacerbation of Chronic Bronchitis

An acute exacerbation of chronic bronchitis is a noticeable worsening of usual cough, sputum or breathlessness in someone with chronic bronchitis or COPD.

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Key takeaways

  • Viral infection, bacterial infection and air pollutants can look similar, so antibiotics are not needed for every flare.
  • A written action plan helps distinguish manageable changes from symptoms that require urgent assessment.
  • Oxygen level, breathing effort, other illnesses and previous exacerbations influence treatment and place of care.

The listings below are not proof of a bacterial flare; treatment should follow clinical assessment and the person’s COPD plan.

What changes during a flare

Cough may become more frequent, sputum may increase or change colour, and ordinary activity may cause more breathlessness. Pneumonia, heart failure and a blood clot can mimic an exacerbation, particularly when chest pain, fever or sudden breathlessness is prominent.

Treatment roles

Short-acting inhaled bronchodilators are commonly intensified. A short corticosteroid course may be used in selected exacerbations, while antibiotics are considered when bacterial features or higher clinical risk are present. Technique, adherence and current inhalers should also be reviewed.

When to seek urgent care

Seek urgent care for severe or rapidly worsening breathlessness, blue or grey lips, confusion, drowsiness, chest pain, coughing blood or inability to speak in full sentences.