Respiratory

Viral Bronchitis (Viral LRTI)

وائرل برونکائٹس

Low-grade fever with a painful dry cough and a clear chest; CBC shows lymphocytosis.

ICD-10: —
Source: OPD handbook pp.32–35
Status: Draft

Not yet reviewed by a clinician. Check doses and brands against current national guidelines before use.

Symptoms

Fever: low grade
Cough: painful and dry
Body aches

Diagnosis

Chest clear
Temperature about 100 °F
Associated runny nose
CBC: raised WBC with predominant lymphocytes

Treatment

Step 1 of 5

1. Antibiotic of choice

Paediatric dose 10 mg/kg OD

Prescription

AzithromycinMacrolide antibiotic

Dose500 mg OD (adult); 10 mg/kg OD (child)

Brand Azitma / Arzomic / Gazitharo / Zyto

Also sold as Zithromax, Azomax, Azitma, Arzomic, Zyto, Genthro

Caution: QT prolongation; caution with other QT-prolonging drugs

Step 2 of 5

2. Steroids

Indicated; adult dose 1 mg/kg
Steroid of choice in paediatrics: betamethasone 5 units/kg (100 units = 1 mg), i.e. Tab Betnisol 0.5 mg: 1 year ½+½; 2–5 years 1+1

Prescription

PrednisoloneCorticosteroid

Dose1 mg/kg (adult)

Brand Rapicort 5 mg / Deltacortil 5 mg

Also sold as Deltacortril, Rapicort, Rapicort EC, Prednisolone 5 mg

BetamethasoneCorticosteroid

DoseChild: 1 year ½+½; 2–5 years 1+1

Brand Betnisol 0.5 mg

Also sold as Betnisol, Betnelan

Step 3 of 5

3. NSAIDs

Prescription

Paracetamol (Acetaminophen)Analgesic / antipyretic

Dose2 tabs TDS

Brand Panadol

Also sold as Panadol, Calpol, Febrol, Pedrol, Calpol 6 Plus (250 mg/5 mL)

Caution: Do not exceed 4 g/day in adults or 60 mg/kg/day in children; Avoid in severe liver disease

IbuprofenNSAID

Dose200–400 mg TDS

Brand Brufen

Caution: Avoid in dengue (bleeding risk); Avoid in kidney disease, peptic ulcer, late pregnancy; Take with food

Step 4 of 5

4. Cough suppressant

Ivy leaf is best

Prescription

Ivy leaf extract (cough syrup)Herbal cough suppressant / expectorant

Dose2 tsf TDS

Brand Syp Samvy / Prospan / Hylixia

Also sold as Prospan, Samvy, Hylixid, Coferb Plus, Hylixia

Step 5 of 5

5. PPI (with steroids)

To prevent steroid-induced GI upset

Prescription

OmeprazoleProton pump inhibitor

Dose20 mg BD

Brand Risek / Teph / Ruling

Also sold as Risek, Teph, Ruling, Ruling sachet, Omega

EsomeprazoleProton pump inhibitor

Dose20 mg BD

Brand Novoteph / Esante / Eskem

Also sold as Novoteph, Esante, Eskem, Eswin, Nexum, Esso, Exium

Sample prescription from the book (patient details removed)

Adult female, 20 y, fever and dry painful cough, chest clear, T 100 °F: Tab Azitma 500 mg 1+0; Tab Panadol 2+2+2; Tab Rapicort 5 mg 3+3; Cap Ruling 20 mg 1+1; Syp Hylixia 2 tsf 2+2+2.