Antibiotics May Not Help A Cough

Amid growing concern about the overuse of antibiotics, a new study shows they frequently make no difference against bad coughs, a condition they're commonly prescribed to fight.

The study, in the Journal of the American Medical Association, looked at more than 500 people diagnosed with acute bronchitis or pharyngitis, and found their coughs lasted about 12 days after a visit to the doctor whether antibiotics were prescribed or not, says The Early Show medical correspondent Dr. Emily Senay.

The researchers compared different treatment strategies, and found little difference whether antibiotics were given immediately, delayed, or not given at all.

"The bottom line was that it didn't matter," Senay told co-anchor Harry Smith. "The coughs lasted about 12 days with or without antibiotics. These people got better whether or not the antibiotics were present.

"And that really tells us something important, that, in many cases, almost all cases when you have a healthy person …they will get better on their own. These were all healthy people. They did not have underlying heart, lung, or asthma problems.

"People who have underlying medical conditions, such as pneumonia, clearly need antibiotics" to help avoid complications, Senay added. "And there are studies that say these people do get better."

Doctors prescribe antibiotics to tens of millions of people each year for the deep, hacking cough of bronchitis and pharyngitis, and it's thought many of those prescriptions are unnecessary. Many coughs are caused by viral infections, which aren't treatable with antibiotics. There's an ongoing debate about the best way to reduce the number of prescriptions.

Antibiotics "can be very useful in treating bacterial infections, Senay points out. "But their overuse can result in germs that develop resistance to antibiotics over time. Drug-resistant germs can cause serious infections that are difficult to treat.

"A lot of patients have come to expect and will demand antibiotics as an immediate treatment for a bad cough. Often, a doctor will prescribe them without trying any other avenues first," Senay observes.

"When you don't need a medication," she adds, "you expose yourself to the potential risk of side effects for unnecessary reasons. It also costs our health care system a tremendous amount of money," with estimates running as high as $800 million a year.

Antibiotics have been the standard of care for a long time, Senay notes, and not all doctors will agree with the conclusions of the new study. But an editorial in the journal urges doctors to "do the right thing" by taking into account the new information, informing patients that whether or not they end up taking antibiotics, the symptoms are likely to last the same amount of time, and at least hold off on the immediate prescription of antibiotics in cases where there is no pneumonia or other risk factors.

The editorial suggests delaying antibiotics may help address the problem of patients who expect the drugs automatically.

Bottom line? Ask your doctor for guidance, Senay urges, but don't automatically insist on a prescription for antibiotics for a bad cough. There are other good ways to treat those symptoms.