Managing the older bronchitis patient

In this era of cost containment, it is not appropriate to obtain a complete blood cell count, Gram's stain of sputum, sputum culture, or blood cultures for elderly outpatients with an exacerbation of chronic bronchitis. For monitoring antibiotic therapy of infectious exacerbations, clinicians rely on the patient's observations that dyspnea is less severe, and that sputum volume is reduced and appears more mucoid than purulent. These criteria may be rudimentary, but they have withstood the test of time.