A patient with acute bronchitis presents with foul-smelling sputum. What should the nurse practitioner prescribe?

In cases of acute bronchitis, particularly when presented with foul-smelling sputum, it is important to consider the possibility of a bacterial infection, such as those caused by atypical bacteria that can lead to increased sputum production with a distinct odor. The use of a macrolide antibiotic is appropriate in this context due to its effectiveness against a range of pathogens, especially atypical bacteria like Mycoplasma pneumoniae and Chlamydophila pneumoniae, which are common in bronchitis cases and can produce foul-smelling sputum.

Macrolides, such as azithromycin or clarithromycin, are often chosen because they not only target these atypical organisms but also have good penetration into the respiratory tissues and fewer side effects compared to other classes of antibiotics. This makes them suitable for treating acute bronchitis symptoms in patients presenting with these specific clinical signs.

In contrast, other options may not be as effective in this situation. Theophylline is primarily used for chronic conditions like asthma or COPD, not for acute bronchitis presenting with bacterial signs. A PCN (penicillin) antibiotic may not cover the atypical pathogens effectively, as it primarily works against typical bacterial infections. An inhalable corticosteroid is focused on reducing inflammation in chronic