BACKGROUND The evidence for the diagnosis and management of cough due to acute bronchitis in immunocompetent adult outpatients was reviewed as an update to the 2006 American College of Chest Physicians (ACCP) Evidence-Based Clinical Practice Guideline Cough due to Acute Bronchitis. METHODS Acute bronchitis was defined as an acute lower respiratory tract infection manifested predominantly by cough with or without sputum production, lasting no more than 3 weeks with no clinical or any recent radiographic evidence to suggest an alternative explanation. Two clinical PICO (Population, Intervention, Comparison, Outcome) questions were addressed by systematic review in July 2017: firstly, the role of investigations beyond the clinical assessment of patients presenting with suspected acute bronchitis; and secondly, the efficacy and safety of prescribing medication for cough in acute bronchitis. An updated search was undertaken in May 2018. RESULTS No eligible studies relevant to the first question were identified. For the second question, only one relevant study met eligibility criteria. This study found no difference in number of days with cough between patients treated with an antibiotic or an oral non-steroidal anti-inflammatory agent compared with placebo. Clinical suggestions and research recommendations were made based on the consensus opinion of the CHEST Expert Cough Panel. CONCLUSION The panelists suggested that no routine investigations be ordered and no routine medications be prescribed in immunocompetent adult outpatients first presenting with cough due to suspected acute bronchitis, until such investigations and treatments have been shown to be safe and effective at making cough less severe or resolve sooner. If the cough due to suspected acute bronchitis persists or worsens, a reassessment and consideration of targeted investigations should be considered.

中文翻译：

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免疫功能正常的成人门诊因急性支气管炎引起的急性咳嗽：胸部专家小组报告

背景 免疫功能正常的成人门诊患者因急性支气管炎咳嗽的诊断和治疗证据被审查为 2006 年美国胸科医师学会 (ACCP) 循证临床实践指南急性支气管炎咳嗽的更新。方法 急性支气管炎被定义为一种急性下呼吸道感染，主要表现为咳嗽伴或不伴咳痰，持续时间不超过 3 周，没有临床或任何近期放射学证据表明其他解释。2017 年 7 月的系统评价解决了两个临床 PICO（人群、干预、比较、结果）问题：首先，调查在对疑似急性支气管炎患者的临床评估之外的作用；其次，急性支气管炎咳嗽处方药的疗效和安全性。2018 年 5 月进行了更新搜索。 结果 未确定与第一个问题相关的符合条件的研究。对于第二个问题，只有一项相关研究符合资格标准。该研究发现，与安慰剂相比，接受抗生素或口服非甾体抗炎药治疗的患者的咳嗽天数没有差异。临床建议和研究建议基于 CHEST 咳嗽专家小组的共识意见。结论 小组成员建议，对于因疑似急性支气管炎而首次出现咳嗽的免疫功能正常的成人门诊患者，无需进行常规检查，也无需处方常规药物。直到此类调查和治疗被证明可以安全有效地减轻咳嗽的严重程度或更快地消退。如果疑似急性支气管炎引起的咳嗽持续或恶化，应考虑重新评估和考虑有针对性的检查。