A patient with acute bronchitis and a history of smoking presents with a productive cough of foul-smelling sputum. What prescription should the nurse practitioner consider?

In the case of a patient with acute bronchitis, particularly one who has a history of smoking and presents with a productive cough accompanied by foul-smelling sputum, the need for effective management is crucial. The presence of foul-smelling sputum may suggest a secondary bacterial infection, which is not uncommon in smokers who can have chronic airway issues.

Macrolide antibiotics are a suitable choice in this scenario because they are effective against typical and atypical respiratory pathogens. They also have anti-inflammatory properties that can be beneficial in managing respiratory conditions, particularly in patients where bacterial superinfection is suspected.

While penicillin antibiotics may also address some bacterial infections, they may not cover all the potential pathogens that cause acute bronchitis. Theophylline is primarily used for chronic obstructive pulmonary disease (COPD) and asthma management, and inhalers might be appropriate for symptomatic relief but do not treat the underlying infection if one is present. Thus, prescribing a macrolide antibiotic would be the most appropriate choice for the management of this patient’s condition, addressing the likelihood of a bacterial etiology and providing symptomatic relief.