Many People Underestimate How Long a Cough Should Last

MONDAY Jan. 14, 2013 -- You've been hacking and coughing for a week now -- isn't it time that the cough was through?

Sadly, the answer is often "no," and experts report that many people have a mistaken idea of how long an acute cough should last. This misconception can lead to the unnecessary (and, for public safety, dangerous) overuse of antibiotics, a new study finds.

"No one wants or likes a lingering cough. Patients simply want to get rid of it," said Dr. Robert Graham, an internist at Lenox Hill Hospital in New York City.

"After exhausting over-the-counter regimens for about a week, they visit their doctors with the hopes of obtaining a prescription antibiotic for a self-limited condition [that is] usually caused by viruses," which do not respond to antibiotics, said Graham, who was not involved in the new study.

So how long does the average acute cough really last? The team of researchers from the University of Georgia, in Athens, reviewed medical literature and found that the average duration of an acute cough is nearly three weeks (17.8 days).

They then surveyed nearly 500 adults and found that they reported that their cough lasted an average of seven to nine days. And if a patient believes an acute cough should last about a week, they are more likely to ask their doctor for antibiotics after five to six days of having a cough, the researchers noted.

The trouble is, these patients can then be fooled into thinking that the antibiotic helped. If a patient begins taking the drug seven days after their cough began, they may begin to feel better naturally three to four days later, with the cough disappearing 10 days later. That coincides with the average duration of an acute cough and could lead a patient to incorrectly believe that the antibiotics cured their cough, the researchers explained.

Needlessly prescribing antibiotics for virus-linked coughs is another cause of antibiotic overuse, and the overuse of antibiotics can foster genetic mutations that help germs resist the drugs, experts note.

Therefore, it's important for doctors to explain to patients how long an acute cough typically lasts, the researchers said.

Graham agreed. "This study is a great reminder to doctors to remember that the evidence once again says no antibiotics for cough," he said. "Time may be the best medicine we can offer our patients."

Dr. Neil Calman is chairman of the department of family medicine and community health at the Icahn School of Medicine at Mount Sinai in New York City. He said the scenario described in the study is all too familiar.

"Oftentimes, unnecessary [medicating] is the result of impatience on the part of the patients to get better and the failure of [doctors] to know and/or explain to their patients [the realistic] expectations for the partial or complete resolution of their symptoms," he said.

"This study is important in reminding providers that the resolution of cough in an acute illness will often take weeks, and, further, in reminding us of the importance of informing patients of those expectations," Calman said.

The study appears in the January/February issue of the journal Annals of Family Medicine.

More information

The U.S. National Heart, Lung, and Blood Institute has more about cough.

Posted: January 2013


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