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Antibiotic Prescribing for Cough and Symptoms of Respiratory Tract Infection
Do the Right Thing
Mark H. Ebell, MD, MS
JAMA. 2005;293:3062-3064.
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Cough is the third most common reason that patients present to physicians for care and was responsible for 3.2% of all outpatient visits in the United States in 2002.1 Of these visits, more than 30 million were made for a chief complaint of cough, at least 10 million of which were made by otherwise healthy adults diagnosed with acute bronchitis; most of these patients received an antibiotic prescription, often for a broad-spectrum macrolide or quinolone costing US $50 to $100.1-4
Although acute cough in healthy adults is common and treatment is a significant expense, the evidence on which treatment decisions are based is relatively limited; until recently, it consisted primarily of 9 studies with 750 patients, many performed a decade or more ago.5 A systematic review of these studies suggests a small benefit for antibiotics, with cough resolving about a half day sooner, balanced by . . . [Full Text of this Article]
Author Affiliation: College of Human Medicine, Michigan State University, East Lansing.
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