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Chronic bronchitis. Choosing the optimal treatment.

Among the various therapies for chronic bronchitis none is more important, both for relieving symptoms and for preserving pulmonary function, than cessation of cigarette smoking. Unfortunately, even when patients are motivated and programs are aggressive, results are unspectacular. Chronic bronchitis often responds favorably to bronchodilating agents. For initial therapy, ipratropium bromide (Atrovent) is the agent of choice because of its efficacy and safety. The role of antiinflammatory drugs is not yet clear, although inhaled steroids are beneficial in some patients. Most patients improve with smoking cessation and/or judicious pharmacologic intervention.