The researchers looked at data in 19 studies that included 23 to 1,230 subjects each to find out how long an acute cough lasted in patients with acute bronchitis — a condition people often refer to as a chest cold (as opposed to a head cold in which the symptoms are mostly nasal). They found the average duration of a cough among the people in the studies was 17.8 days. Then they surveyed almost 500 adults to find out if their expectations for how long a cough should last matched up with clinical data. In the survey, they asked about 500 Georgia residents 18 years-old and older, “[S]uppose that you get sick and the main symptom is a cough. You are coughing up yellow mucus and have a slight fever. You are not taking any medicine for the cough. About how long do you expect that it will take from the time you first feel sick until the time where you feel well and the cough is gone?” Study author Mark Ebell, MD, Associate Professor at the College of Public Health at the university, says that those polled generally thought a cough should last an average of seven to nine days. Men and nonwhite respondents predicted a shorter cough duration, while those with self-reported asthma or chronic lung disease predicted a longer cough duration. “I knew that bronchitis will often last a couple of weeks, but I wanted to see if this was my impression or if it is real,” says Dr. Ebell. “[Now] we have pretty good evidence the mismatch [between patient expectations and clinical data] is real, so we need to do more to educate patients about what they can expect when they get a chest cold.” He says he often sees patients in his practice who, if they don’t get better from bronchitis after four or five days, think they need antibiotics. “As soon as people see a doctor" for a cough or cold, he says, “60 percent or more will get an antibiotic for it, while only a small percentage would need an antibiotic or benefit from it.”
The Downsides of Antibiotics
Of course, some people with a chest cold or cough should seek treatment from a doctor: those who are chronically ill, elderly, or very young, or patients who are short of breath or cough up blood. But most people don’t fit in those categories and could ride out the sickness and let the cough run its course — without taking antibiotics, says Ebell. There are many downsides to taking antibiotics. One of the main reasons physicians worry about over-prescription of antibiotics is that they are concerned bacteria will become resistant to the medicines available, which could be dangerous for those who develop pneumonia or another serious infection and desperately need antibiotics to work. Another reason is nasty side effects. About 10 to 20 percent of those that take antibiotics experience diarrhea, nausea, or vomiting, and in some cases people develop severe diarrhea that can be life-threatening and lead to hospitalization, Ebell says. There’s also the cost of antibiotics. Going to the doctor and paying for antibiotics is a lot more costly and time-consuming than simply going to the nearest drug store for an over-the-counter cough medicine, Ebell says: “We spend so much more than any other country in the world on healthcare because we’re spending money on things that don’t make us healthier, and this is a good example of that.” The study was published in the January/February issue of the Annals of Family Medicine. While many coughs can be treated with an over-the-counter cold medication and Mom’s advice to rest up and drink lots of fluids, sometimes a cough is a sign of something more serious than a cold. Make sure you see a doctor if your cough is accompanied by chest pain, wheezing, or shortness of breath, if you cough up blood or yellow or green mucus, if you have a fever of 101 or higher, if you’ve lost weight, or if you’re soaking the sheets with night sweats. A cough that lingers past eight weeks is considered a chronic cough and could be related to gastroesophageal reflux disease, chronic obstructive pulmonary disease, asthma, allergies, smoking, and in rare cases, even lung cancer. TELL US: Have you ever gone to the doctor and asked for antibiotics because you had a lingering cough? (Note: Mobile users may not be able to comment).
