Does Prolonged Condition Require Antibiotics? Physician Says No

Prolonged cough doesn't always need medications. A physician explained why.

Why Prolonged or Postinfectious Cough Doesn't Need Medication?

A postinfectious cough persists for weeks after the original infection has cleared up, and it is being experienced by many people in Canada due to the current wave of respiratory diseases.

Here are five points about prolonged cough.

1. Respiratory infection that may linger for eight weeks.

2. A prior respiratory infection and exclusion of various postinfectious cough mimics, such as asthma and chronic obstructive pulmonary disease, are necessary for the diagnosis.

3. Assess for warning signs and length of cough. Investigating symptoms such as trouble swallowing, severe dyspnea, and blood in the cough may be necessary. A history of recurrent pneumonia or a prolonged history of smoking are warning signs, and coughs that persist longer than eight weeks require additional evaluation.

4. There is insufficient proof to support the efficacy of any medicine in treating postinfectious cough. There is little evidence that using inhalers or oral drugs to treat coughs would help. These drugs can have unfavorable side effects in addition to being highly expensive.

5. Education and patient comfort are essential. If a patient's cough does not clear up after eight weeks or new symptoms manifest, clinicians should suggest that the patient schedule a follow-up session for additional testing.

However, this condition reportedly doesn't need any medication as it usually resolves independently.

"Reassuring patients that postinfectious cough is time-limited and self resolving is important and can reduce unnecessary and costly prescriptions, such as asthma puffers or antibiotics," said Dr. Kevin Liang, a family physician and clinical instructor in the Department of Family Practice at the University of British Columbia, Vancouver, BC. "Most postinfectious cough symptoms will improve without medication."

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What Is Postinfectious Cough?

Postinfectious or post-viral coughs are after-effects of an upper respiratory infection, such as a common cold. After a viral infection, they may persist for three to eight weeks.

Adults who experience a post-viral cough typically have two causes:

* Postnasal drip: a condition in which mucus runs down your throat

* Inflammation resulting from the original respiratory illness or enlarged airways

During the day, postnasal drip might irritate your vocal cords and throat. According to Russell Buhr, MD, PhD, a UCLA Health pulmonary and critical care physician, it worsens at night.

 "When you're lying flat at night, mucus runs down the back of your throat and into your lungs," the physician said. "It can cause chest congestion that needs to be coughed up. When mucus travels down your throat, it can also cause irritation and inflammation, making you cough."

After an upper respiratory infection, the infection is usually the source of coughing. However, in certain instances, a persistent cough could be a sign of a secondary infection that developed. At the same time, your immune system was preoccupied, which could indicate pre-existing asthma that the previous virus exacerbated.

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