The study by researchers at Georgetown University found that the use of antibiotics did not have any noticeable effect on the severity or duration of coughs, even when there was a bacterial infection present. This conclusion was drawn from a large, prospective study of individuals seeking treatment for lower-respiratory tract infections in primary or urgent care settings in the United States.Georgetown University Medical Center and colleagues published a study on April 15, 2024, in the Journal of General Internal Medicine.
According to the study’s lead author, Dan Merenstein, MD, professor of family medicine at Georgetown University School of Medicine, upper respiratory tract infections typically include the common cold, sore throat, sinus infections, and ear infections. There are established methods for determining whether antibiotics are necessary for these types of infections.
Lower respiratory tract infections, on the other hand, have the potential to be more dangerous, as approximately 3% to 5% of these patients develop pneumonia. However, not everyone has easy access to X-rays during their initial visit.The study found that clinicians often prescribe antibiotics for coughs despite lack of evidence of a bacterial infection, and patients have come to expect antibiotics even if they may not be effective. However, most cases of infections can be resolved with basic symptom-relieving medications and time without the need for antibiotics. The antibiotics prescribed in the study were commonly used for treating bacterial infections, but the analysis showed that they had no significant effect on the duration or severity of coughs compared to those who did not receive them.Those who didn’t receive an antibiotic.
“Doctors are aware of, but may overestimate, the proportion of lower respiratory infections that are caused by bacteria; they also probably overestimate their ability to differentiate between viral and bacterial infections,” explains Mark H. Ebell, MD, MS, a professor in the College of Public Health at the University of Georgia and one of the study’s authors. “In our analysis, 29% of individuals were prescribed an antibiotic while only 7% were given an antiviral. However, most patients do not require antivirals, as there are only two respiratory viruses for which we have medications to treat them: influenza and SARS-COV-2. There are no medications available for all of the other.”
Researchers conducted a study to distinguish between bacterial and viral infections in patients with symptoms of a cough. They used advanced lab tests to confirm the presence of pathogens, categorizing the results as only bacteria, only viruses, both virus and bacteria, or no organism detected. Importantly, they found that the duration of illness was the same for those with a confirmed bacterial infection whether they received antibiotics or not – around 17 days.
Excessive use of antibiotics can lead to symptoms such as dizziness, nausea, diarrhea, and rash, in addition to 4% chance of serious adverse effects such as anaphylaxis, a severe and life-threatening allergic reaction; Stevens-Johnson syndrome, a rare and serious skin and mucous membrane disorder; and Clostridioides difficile-associated diarrhea. Overusing antibiotics also raises concerns about resistance. The World Health Organization warned on April 4, 2024, that uncontrolled antimicrobial resistance due to antibiotic overuse is expected to decrease life expectancy and result in unprecedented health costs and economic losses.
“We are aware that a cough can be a sign of a significant conditionThe issue of cough is the most common reason for people to seek ambulatory care, resulting in almost 3 million outpatient visits and over 4 million emergency department visits each year,” explained Merenstein. “There is a need for further research on the serious symptoms of cough and how to properly treat them. This could be studied in a randomized clinical trial, as our study was observational and there have been no randomized trials on this issue since around 2012.
