Do I Need Antibiotics for My Cough?


Taking antibiotics when you don’t need them isn’t just wasteful; it can be harmful, too. In addition to promoting antibiotic resistance (where bacteria develop the ability to resist antibiotic treatment), antibiotic use accounts for about one in five emergency department visits for drug-related adverse events.

If you’re still unsure about whether or not you need antibiotics for your cough, here are some facts to reassure you that supportive care may be all you need.

 

 

What should you expect with acute bronchitis?

If your cough persists for more than five days, you likely have acute bronchitis. In fact, coughing in patients with acute bronchitis usually lasts about 10 to 20 days. According to one study, cough disappeared by day 14 in three-quarters of patients with viral bronchitis, but it varies across studies. Some other studies found that the average duration of cough with acute bronchitis was an average of 24 days. With acute bronchitis, it’s also possible for you to experience sputum (or phlegm) with your cough.

 

Should acute bronchitis be treated with antibiotics?

Multiple studies show that people with acute bronchitis do NOT experience much benefit from antibiotic therapy, if any. In one study, for example, taking antibiotics (either Augmentin or amoxicillin) was no more effective at decreasing the duration of a cough compared to taking an over-the-counter pain reliever (ibuprofen) or doing nothing.

 

 

How do doctors diagnose acute bronchitis?

For most patients with acute bronchitis, diagnosis is based on your medical history and a physical examination. Further testing is usually not needed, but a chest x-ray may be done if you have an abnormally fast heart rate or breathing rate, if you have a fever, or if you are over 75 years of age.

 

What works to treat acute bronchitis?

A nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen (Motrin, Advil), aspirin or acetaminophen (Tylenol) may help ease some of the chest discomfort that comes with acute bronchitis.

However, inhalers, cough suppressants and decongestants may not be as effective. Studies show that inhalers like albuterol (Proventil, Proair) aren’t helpful for treating acute bronchitis. Likewise, prescription cough suppressants like Tessalon (benzonatate) and codeine cough syrups may work but not very well. And over-the-counter medications like Mucinex,Dimetapp and Delsym were found in studies to be ineffective for acute coughs.

Actually, honey suppresses cough better than over-the-counter meds in children (and possibly adults) by forming a soothing film over irritated throats.

 

 

What kind of cough does need antibiotics?

Unlike acute bronchitis, pneumonia, which can also cause a long-term cough, does require antibiotic therapy. Pneumonia looks very similar to the flu, though, so you’ll have to see a doctor to find out whether you need antibiotics. (Flus are caused by viruses and don’t require antibiotics.)

The presence of a fever may be a clue that your cough is either caused by the flu or pneumonia rather than acute bronchitis. Symptoms of the flu and pneumonia also include body ache, headache, fatigue, nausea and a loss of appetite, which don’t happen with acute bronchitis. On the other hand, chest pain and wheezing are more common with acute bronchitis.

 

Dr O. 

 

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