[Antibacterial therapy of acute exacerbated chronic bronchitis]

An early therapy of the acute exacerbation is important for the long-term prognosis of chronic bronchitis. The aim of the therapy is to stop the progressive damage of the bronchial mucosa. The typical clinical symptoms and the knowledge of the usual pathogens (in at least 80% hemophilus influenzae and streptococcus pneumoniae) allow a "blind" chemotherapy with aminopenicillins, tetracyclines and the trimethoprim-sulphonamide combination as medication of choice. The treatment is successful when the purulent sputum turns mucoid within 2 to 5 days and the symptoms improve. If this does not happen, culture and antibiogram should be made and chemotherapy chosen according to the findings. The acute exacerbation can be complicated by an airway obstruction. In this case the short-term application of glucocorticoids in combination with bronchodilators and secretolytics is suggested.