Bronchitis - Uncomplicated Acute Drug Summary

Last updated: 17 October 2025
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Antibacterial Combination

Content on this page:

Antibacterial Combination

Antibacterial Combination


Drug Dosage Remarks
Co-trimoxazole 
(Sulfamethoxazole [SMZ] and
Trimethoprim [TM])		 800 mg SMZ and 160 mg TM PO 12 hourly x 14 days
 Adverse Reactions
  • GI effects (nausea/vomiting, anorexia, diarrhea, rarely antibiotic-associated diarrhea/colitis, glossitis); Dermatologic effects (rash, pruritus, photosensitivity); Hypersensitivity effects (eg rash, Stevens-Johnson syndrome); GU effect (crystallization in the urine); Other effects (aseptic meningitis, hepatotoxicity, hematologic effects) 
Special Instructions
  • Maintain adequate fluid intake
  • Contraindicated in patients allergic to sulfonamides
  • Use with extreme caution or not at all in patients with hematological disorders especially megaloblastic anemia due to folic acid deficiency
  • Use with caution in patients with renal impairment or severe hepatic dysfunction and with folate deficiency (may consider administration of folinic acid)

Cough & Cold Preparations


Drug Dosage Remarks
Acetylcysteine 
(N-acetylcysteine)		 200 mg PO 8-12 hourly
300 mg PO 12 hourly or
400 mg PO 8-12 hourly or
600 mg PO 24 hourly preferably at night		 Adverse Reactions
  • GI effects (nausea/vomiting); Hypersensitivity effects (bronchospasm, rashes); Other effect (hypotension) 
Special Instructions
  • Use with caution in patients with gastric or duodenal ulcer, bronchial asthma
  • Acetylcysteine effervescent tab/granules for oral solution: Avoid in patients with phenylketonuria
Ambroxol  30 mg PO 8 hourly 
Extended-release: 
75 mg PO 24 hourly 
Bromhexine1  8-16 mg PO 8 hourly 
Carbocisteine1
(Carbocysteine) 		 500 mg PO 8 hourly or
750 mg PO 8-12 hourly 
Erdosteine 300 mg PO 8-12 hourly Adverse Reactions
  • GI effects (GI discomfort, rarely taste alterations); Other effects (rarely, headache, dyspnea, urticaria, erythema, dermatitis)
Special Instructions
  • Contraindicated in patients with hepatic cirrhosis, hepatic impairment, cystathionine-synthetase enzyme deficiency and severe renal failure
Guaifenesin1 100-200 mg PO 6-12 hourly or 200-400 mg PO 4 hourly 
Max dose: 2,400 mg/day		 Adverse Reactions
  • GI effects (GI discomfort, nausea/vomiting)
Special Instructions
  • Use with caution in patients with persistent or chronic cough, asthma, chronic bronchitis or emphysema
  • Discontinue use if cough persists for >7 days with fever, rash or persistent headache
Lagundi leaves 
(Vitex negundo L)		 300-600 mg PO 6-8 hourly Adverse Reactions
  • GI effects (nausea/vomiting, diarrhea); Other effect (itchiness)
Special Instructions
  • May be taken with or without food
Levodropropizine 60 mg PO 8 hourly Adverse Reactions
  • CNS effects (somnolence, faintness, clouding of consciousness, dizziness, headache); Other effects (palpitation, GI disturbance)
Special Instructions
  • Use with caution in patients with excessive mucus discharge, limited mucociliary function, hepatic dysfunction, renal insufficiency and diabetes
1Combination preparation is available. Please see latest MIMS for specific formulations and prescribing information.

Macrolides


Drug Dosage1 Remarks
Erythromycin Children: 30-50 mg/kg/day PO divided 6 hourly
Adults: 250 mg PO 6 hourly or
500 mg PO 12 hourly		 Adverse Reactions
  • GI effects (nausea/vomiting, abdominal discomfort, diarrhea and other GI disturbances, antibiotic-associated diarrhea/colitis); Other effect (candidal infections)
  • Azithromycin and Clarithromycin tend to cause less GI disturbances than Erythromycin 
Special Instructions
  • May take with food to decrease gastric distress
  • Use with caution in patients with hepatic dysfunction
Roxithromycin Children 6-40 kg: 5-8 mg/kg/day PO divided 12 hourly x 5-10 days
Children ≥40 kg: 150 mg PO 12 hourly x 5-10 days
Adults: 150 mg PO 12 hourly x 5-10 days or 300 mg PO 24 hourly x 5-10 days
Advanced Macrolides
Azithromycin Children: 10 mg/kg PO 24 hourly x 3 days or 10 mg/kg PO 24 hourly x 1 day followed by 5 mg/kg PO x 4 days
Adults: 500 mg PO 24 hourly x 3 days or 500 mg PO 24 hourly x 1day followed by 250 mg PO 24 hourly x 4 days
Clarithromycin  Children: 7.5 mg/kg PO 12 hourly x 7 days
Adults: 250-500 mg PO 12 hourly x 7 days 
¹Duration of therapy is unless otherwise stated: 14 days

Other Drugs Acting on the Respiratory System


Drug Dosage Remarks
Pelargonium sidoides Children 1-5 years old: 6.25 mg PO 8 hourly 
Children 6-12 years old: 12.5 mg PO 8 hourly or 20 mg PO 12 hourly 
Children >12 years old and Adults: 20 mg PO 8 hourly
 Adverse Reactions
  • GI effects (nausea/vomiting, diarrhea); Hypersensitivity effects (rash, urticaria, pruritus) associated with initial dose
Special Instructions
  • Contraindicated in patients with severe renal and hepatic impairment
  • Use with caution in patients with hematologic disorders and in patients taking anticoagulants
  • After symptoms subsides, advise patient to continue use for additional 2 days

Vaccines


Drug Dosage Remarks
Vaccine, influenza, inactivated virus1,2
(Influenza virus strains type A and B determined annually by WHO according to surveillance data)
  • Trivalent influenza vaccine: 2 type A and 1 type B strains
  • Quadrivalent influenza vaccine: 2 type A and 2 type B strains
  • High-dose trivalent or quadrivalent influenza vaccine
 0.5 mL IM/deep SC to be given annually
Dose and route (IM or deep SC administration) will depend on formulation
Please verify dosing with package information		 Adverse Reactions
  • Local effect (injection site soreness); CNS effect (headache); Other effects (GI disturbances, oculorespiratory syndrome, fever, malaise) 
Special Instructions
  • High-dose influenza vaccine is indicated for use in persons ≥65 years old
  • Contraindicated in individuals with severe allergic reaction to any component of the vaccine
  • Use with caution in patients with moderate to severe acute illness and with history of Guillain-Barré syndrome (GBS) 
Vaccine, influenza, purified antigen (Live, attenuated influenza vaccine [LAIV])1
(Influenza virus strains type A and B determined annually by WHO according to surveillance data)		 Only indicated for healthy individuals:
0.1 mL in each nostril as a single dose		 Adverse Reactions
  • Respiratory effects (runny nose, congestion, sore throat, cough); CNS effect (headache); Other effect (fever)
Special Instructions
  • Do not administer parenterally
  • Contraindicated in individuals with severe allergic reaction to any component of the vaccine, pregnant patients, or with severe immunodeficiency
  • Avoid use of antivirals 48 hours before and 14 days after vaccination
  • Use with caution in patients with moderate to severe acute illness, with history of GBS, and close contact with an immunosuppressed individual

Vaccine, influenza, recombinant virus
(Influenza virus strains type A and B determined annually by WHO according to surveillance data)

  • Trivalent influenza vaccine: 2 type A and 1 type B strains
  • Quadrivalent influenza vaccine: 2 type A and 2 type B strains
 0.5 mL IM to be given annually  Adverse Reactions
  • Local effect (injection site soreness, pain); CNS effect (headache); Other effects (myalgia, fatigue, fever)
Special Instructions
  • Contraindicated in individuals with severe allergic reaction to any component of the vaccine
  • Postpone vaccination in patents with acute febrile illness
  • Use with caution in patients with thrombocytopenia or bleeding disorder
Vaccine, influenza, surface antigen, inactivated, adjuvanted with MF59C.1 (Adjuvant vaccine)
Elderly ≥65 years old: 0.5 mL IM single dose into the deltoid muscle
 Adverse Reactions
  • Local injection site reactions (redness, swelling, pain, ecchymosis and induration); Other effects (fever, malaise, shivering, headache, sweating, myalgia, arthralgia)
Special Instructions
  • Not to be administered intravascularly
  • Contraindicated in patients with allergies to aminoglycosides, formaldehyde, cetyltrimethylammonium bromide and polysorbate 80
  • Postpone immunization in febrile illness or acute infection
Vaccine, respiratory syncytial virus (RSV, RSV vaccine) 0.5 mL IM as a single dose Adverse Reactions
  • Local effects (injection site erythema, swelling, pain); CNS effect (headache); Other effects (myalgia, arthralgia, fever, chills)
Special Instructions
  • Postpone vaccination in patients with acute febrile illness
  • Use with caution in patients with thrombocytopenia or any other coagulation disorders
1Influenza vaccine is also available in combination with diphtheria, tetanus, pertussis, hepatitis B and/or polio vaccines. Please see the latest MIMS for specific formulations and prescribing information.
2Various preparations of inactivated influenza vaccines (eg inactivated split virion, inactivated surface antigen, whole-virion, and virosomal adjuvanted) are available.

Disclaimer

All dosage recommendations are for non-elderly adults with normal renal and hepatic function unless otherwise stated. 
Not all products are available or approved for above use in all countries. 
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs. 
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information.