TUESDAY, Dec. 18 (HealthDay News) -- Commonly prescribed
antibiotics don't help cure most coughs in adults, new research
confirms.
Patients with a cough or bronchitis are often prescribed
antibiotics, and previous studies have had conflicting results
about their effectiveness. For this study, researchers randomly
assigned more than 2,000 adults complaining of a cough to take
either the antibiotic amoxicillin for a week or an inactive
placebo.
Overall, the antibiotic was no more effective at relieving
symptoms or their duration than the placebo, the study found. The
findings also held among people who were older than 60.
"The main message here is that antibiotics are usually not necessary for respiratory infections, if pneumonia is not suspected," said Dr. Philipp Schuetz of the Kantonsspital Aarau in Switzerland.
"Only a few patients benefit from antibiotics and these may be identified with new blood tests for bacterial infections," said Schuetz, who wrote an editorial accompanying the study. "Physicians and patients should generally refrain from antibiotic use, yet, if they feel unsure, the blood test helps them to further minimize risks."
Study participants were 18 and older and had sought treatment
for an acute cough -- meaning they'd had the cough for less than a
month -- which is one of the most common illnesses seen by primary
care doctors. There was no reason to suspect that any of them had
the lung infection pneumonia, which is treated with
antibiotics.
Participants took the antibiotic three times daily for seven
days. While they had no better recovery than those taking the dummy
pills, they were more likely to report side effects such as nausea,
rash and diarrhea, according to the study, published online Dec. 19
in
The Lancet Infectious Diseases.
That said, more people in the placebo group did experience new
or worsening symptoms, but this did not occur frequently enough to
justify treating everyone with antibiotics. Thirty people would
need to be treated with antibiotics to prevent one person from
developing new or worsening symptoms, the study found.
The study is the largest to date that shows antibiotics do not
help treat lower-respiratory infections, the researchers say.
Indiscriminate use of antibiotics may also pose risks, Schuetz
said. "The main risk from antibiotics is related to direct side
effects such as severe diarrhea," he said. "The other risk relates
to emergence of multi-resistant bacteria, which on a population
level are a threat to society as antibiotics may not work
properly."
Dr. Len Horovitz, a pulmonologist at Lenox Hill Hospital in New
York City, said that many patients beg for antibiotics to nip a
cold in the bud. "This is not how it works," he said. "Viruses such
as the common cold do not respond to antibiotics."
So what does work? "Comfort care, such as more sleep, drinking
lots of fluids, and using a humidifier at night," he said. "If you
have a cough or lower respiratory tract infection, go to the doctor
and let him examine you." The doctor can take a culture of any
mucus that comes up with the cough to see if there is a bacteria
present, he explained.
"Getting antibiotics for a dry cough without taking a culture is doing a disservice," he said. "There is no benefit and there may be a slight risk."
More information
Learn more about the common cold, at the
U.S. Centers for Disease Control and
Prevention.