Acute exacerbations of chronic bronchitis (AECB) result in increased morbid
ity and mortality. The role of bacteria in AECB, the importance of antimicr
obial therapy, and the choice of antimicrobial agents have been debated for
decades. Fortunately, within the past few years, a number of studies and o
ne consensus statement have been reported that have increased the understan
ding of the role of bacteria in AECB and suggest approaches in selecting an
timicrobial therapy. This article will review these studies and present an
empiric approach in treating AECB based upon the patient's presenting findi
ngs, related risk factors, and potential antimicrobial resistance patterns
that may be encountered.