Rethinking Cough Management | Important Research

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Rethinking Cough Management

Acute cough and respiratory tract infection are used to describe a wide variety of clinical syndromes. Acute cough is a common reason for consulting a general medical practitioner; although antibiotic treatment is often prescribed for this condition, the relative benefits may not outweigh the side effects.

This well-written review of several previous studies examined the use of antibiotics in the management of acute cough, and assessed the effectiveness of antibiotics compared with placebo by way of three measures: the proportion of subjects with productive cough at follow-up (7-11 days after consultation with a general practitioner); the proportion of subjects who had not improved clinically at follow-up; and the proportion of subjects who reported side effects from taking antibiotics or placebo.

Analysis of eight clinical trials revealed that the resolution of cough was not affected by antibiotic treatment, nor was clinical improvement at re-examination. Side effects were significantly more common in the antibiotic group compared with the group which was administered placebo.

Conclusion: Treatment with antibiotics is unlikely to affect the resolution of cough or alter the course of illness. The benefits of antibiotic treatment are marginal and may be outweighed by common side effects.

Fahey T, Stocks N, Thomas T. Quantitative systematic review of randomized controlled trials comparing antibiotic with placebo for acute cough in adults. British Medical Journal, March 21, 1998;316(7135), pp906-910.