• Nigel Stocks, John Turnidge, and Alan Crockett.
• Department of General Practice, University of Adelaide, South Australia. nigel.stocks@adelaide.edu.au
• Aust Fam Physician. 2004 May 1; 33 (5): 297-301.

BackgroundLower respiratory tract infections--acute bronchitis and community acquired pneumonia (CAP)--are important causes of morbidity in Australia. Acute bronchitis is often treated with antibiotics, although the cause is usually viral. Community acquired pneumonia may be fatal, particularly in the elderly, therefore appropriate assessment and management is essential.ObjectiveThis article describes the aetiology, clinical assessment, investigations and management of acute bronchitis and CAP in the community.DiscussionClinical assessment is important for acute bronchitis and CAP, with investigations such as C reactive protein, serology, and chest X-ray informing diagnosis and management of the latter. Causative organisms are usually not identified, but are presumed to be viral for acute bronchitis, and Streptococcus pneumoniae for CAP; although 'atypicals' are also important. Antibiotics should generally not be prescribed for acute bronchitis, however, there is some evidence they may provide limited benefits in patients who have chest signs, are very unwell, are older, have comorbidities, or smoke. In patients with CAP, treated outside of hospital, the combination of amoxycillin and doxycycline/roxithromycin is the treatment of choice.

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