Lingering Cough: When You Need Antibiotics

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When to Treat a Cough With Antibiotics

When to Treat a Cough With Antibiotics | The Survival Doctorby James Hubbard, MD, MPH

In case you haven’t noticed, it’s the cold and flu season. In fact my last few posts have dealt with “Flu Shots: The Good and the Bad,” things you can to do if you get the flu, and “How NOT to Die From the Flu.”

But now, your cold or flu symptoms are over, except for that lingering cough. Do you need antibiotics? How long can a cough linger and just be related to getting over your virus?

Two new studies investigate these questions and give some surprising (at least to me) findings—findings that I think might help you decide for yourself, especially if you can’t get medical help and antibiotics are in short supply.

Article Contents

Is your cough from bacteria?
Antibiotics: benefits vs. harm
How long do coughs linger?
Signs you need antibiotics

Is the Lingering Cough From Bacteria?

First you should know that the majority of bronchial (lung) infections are caused by viruses. Antibiotics don’t kill viruses. And yet we doctors continue to prescribe them for most of those types of infections. Why?

Well, for one reason we’re trying to please you patients. I know that’s a kind of wimpy excuse but it’s true. Many patients get upset if they’ve gone to the trouble to come in for an office visit for a lingering cough, and all they hear is that it’s probably viral; take some over-the-counter somethings and it’ll run its course. Many see it as wasted time and money.

So, prescribing antibiotics is easier than asking you to wait, give your body a chance to fight it off, and come back if you’re not better in a week or two.

Don’t like that excuse? Okay, how about this? We’re afraid we’re going miss the few episodes of bronchitis (inflammation in the lungs that causes coughing) that are bacterial. Even from a detailed history and exam, it can be hard to tell for sure. We’re worried we might miss one, and then you have to come back in worse than ever, or even end up in the hospital—or that we might be missing an early bacterial pneumonia. You can die from that you know.

So what’s the big deal? Why not just antibiotics for all? Find out why on the next page.

>> Next: Antibiotics: benefit versus harm

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Photo by sarahluv on Flickr.

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  • http://facebook Shirley Ferguson

    I was on a ventilator in 2008 for 13 days because of pneumonia after surgery. I had sx. last July & developed pneumonia again. I have a cough ever so often w/ no other symptoms, do u think I may have lung damage from the ventilator & it’s just now showing up? Thank you for a response.

    • old RT

      I hope S-Doc wont mind me replying to the question of “ventilators”. Surprisingly the lungs are a very durable, stong and complex organ system and really can take a lot of abuse (consider the pressures created during a cough or even sneeze!) Seeing you said you were on a suport system back in 2008 Im sure the use of the most current systems were used which are highly sophisticated and sensitive to the patient’s pressure and volume changes. Surprisingly “ventilators” have bee naround since well back into the 1920s. The real advancement occured mostly after WW2 when to different Doctors/scientists, Dr Bird and Dr Bennett (they had both developed life support systems for high altitude flying) came out with their versions of the Bird ventilators and Bennett Ventilators and it radically evolved from there to the extremely sensetive and well designed support systems of today.
      As a side note, How many recall the “Iron Lungs” of the 30’s,40’s and 50’s during the Polio outbreaks,

      do a wiki search to see photos of those tanks !

      • James Hubbard, M.D., M.P.H.

        Old RT, I’ve seen the iron lungs on TV, never in person.

        • old RT

          A long time ago (but in this galaxy) while at the U of Mo, where I took my training, They had one still in a warehouse and the class went over to look it over. We all got a turn to “try it out”. That was a unique experience !

          • James Hubbard, M.D., M.P.H.

            I’ll bet it was, old RT. Thanks.

    • James Hubbard, M.D., M.P.H.

      Shirley, I suppose that is a possibility. Please, also read my post on other things that can cause a cough. the link is at the end of my current post.

  • Stephanie

    What is the best way to save antibiotics? Can they be used past the expiration date? What if they don’t have an expiration date on them? I can get them overseas when I travel and they are very cheap. But I never know how I should save them. In the refrigerator or a cupboard? They are pill form and they are in a card with bubbles. (The kind you push the pill thru the back of the card) What other things should I get for prepping. I can get several types of antibiotics for a 10 day regimine for just a dollar or so. I try to bring home 3-4 types each time we go. (VietNam)

    • James Hubbard, M.D., M.P.H.

      Stephanie, the best way to store antibiotics is in a cool, dry, dark place. A refrigerator’s fine, but so is a cupboard. No direct sunlight, no excessive heat is the key. Most antibiotics are effective for years after their expiration date. Tetracycline may be an exception.

      • Stephanie

        Thank you, I try to get a broad spectrum supply each time so that we have a supply of everything. It is amazing to me that I can get 4 different types of antibiotics in 10 day to 2 week supply for only 5$ for all of them. Many of the pharmacists are trained in the US or Europe. Most speak good English and all the packaging is English. I a thinking of buying my URSO there next time.

  • James Hubbard, M.D., M.P.H.

    Thanks, old RT. All good and wise suggestions.

  • old RT

    As an “OLD RT’ Respiratory therapist for regular folk, One mi8ght say I (we) are the experts on cough. In over 30 yrs Id have to day Ive listened to many varieties and reasons/causes for a cough. Of the things that are controllable in most situations is the humidity of the air we breathe in in home or outside. The lungs want warm (98.6F) and moist (100%) air anything less starts to strain the system and may result in iritations and coughing. To often as Im at work or in public places Ill hear someone coughing, dry, wet, hoarse, etc, and can nearly visualize what is occuring in their lungs. I an so distressed when I hear the “smokers cough” and then see the apparent age of the individual and I want to tell them the road they are traveling down in regards to their health. Ill hear the cough/choke in a eating establishment and catch my breathe waiting for the next sound of someone being able to breathe. I can at least confess Ive never had to “do” anything for someone choking (yet).