A 35-year old woman complains of a three day history of cough productive of moderate amounts of greenish sputum. Her illness started six days ago with a sore throat that was followed by nasal congestion, a brief episode of hoarseness, and then the cough she currently has. The nasal congestion, sore throat, and hoarseness have all resolved but the cough seems to be getting worse. She feels a mild tightness substernally and has occasional wheezes, but she denies any shortness of breath, fever, or pleuritic chest pain. She has no history of asthma and has never smoked cigarettes. On physical exam you find only a few scattered rhonchi bilaterally. Otherwise the physical exam is entirely normal. You make a diagnosis of acute bronchitis and the patient says she has usually been prescribed an antibiotic for this type of problem in the past.

Although you have prescribed antibiotics for similar patients in the past, you have recently heard that antibiotics may not be indicated in all cases of bronchitis. You wish to find out whether an antibiotic would be appropriate for this patient.