Newer oral antimicrobials and newer etiologic agents of acute bronchitis and acute exacerbations of chronic bronchitis.

Although the role of antimicrobial therapy in the treatment of chronic bronchitis is unproven, physicians continue to look for microbial etiologies to explain episodes of clinical acute bronchitis and better antimicrobial agents with which to treat these episodes. The newest major pathogen of acute bronchitis is Branhamella catarrhalis, a neisseriae-like organism that has become the third most commonly recognized cause of this disease after Haemophilus influenzae and Streptococcus pneumoniae. Because it produces beta-lactamase, B catarrhalis presents a special problem in drug therapy. A number of newer antimicrobials have been introduced which offer potential in the therapy of acute bronchitis, including the enteric coated erythromycins, several new oral cephalosporins, and a large new class of drugs called the fluorinated quinolones. This report addresses the current level of knowledge on these newer agents and therapies of acute bronchitis.