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Study finds antibiotics ineffective for cough treatment in lower respiratory tract infections

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Even the presence of bacterial infection did not show a measurable impact

Antibiotics for lower respiratory infection: ©Greenapple78 - stock.adobe.com

Antibiotics for lower respiratory infection: ©Greenapple78 - stock.adobe.com

A study conducted by researchers at Georgetown University Medical Center and their colleagues examined the effectiveness of antibiotics in treating coughs associated with lower respiratory tract infections. The findings, published in the Journal of General Internal Medicine, reveal that despite the presence of bacterial infections, antibiotics provided no measurable impact on the severity or duration of coughs.

Lead author of the study, Dr. Dan Merenstein, emphasized the widespread misconception surrounding the necessity of antibiotics for lower respiratory tract infections. "Lower respiratory tract infections tend to have the potential to be more dangerous, but not everyone has easy access to immediate diagnostic tools like X-rays," said Dr. Merenstein in a statement. "This often leads clinicians to prescribe antibiotics based solely on symptoms, even though evidence suggests they may not be effective."

The study, which analyzed data from individuals seeking treatment for lower respiratory tract infections in U.S. primary or urgent care settings, revealed that 29% of patients were prescribed antibiotics during their initial visit. However, there was no discernible difference in the duration or severity of coughs between those who received antibiotics and those who did not.

Dr. Mark H. Ebell, a study author and professor at the University of Georgia, underscored the challenge physicians face in accurately distinguishing between bacterial and viral infections. "Physicians may overestimate the likelihood of bacterial infections and their ability to diagnose them," Dr. Ebell noted. "This often results in unnecessary antibiotic prescriptions, despite the limited efficacy of antibiotics in treating viral infections."

To confirm the presence of bacterial or viral infections, advanced lab tests were employed. Even among patients with confirmed bacterial infections, the use of antibiotics did not accelerate the resolution of symptoms. The study found that regardless of antibiotic treatment, the average time until illness resolution was approximately 17 days.

The overuse of antibiotics raises significant concerns regarding adverse effects and antimicrobial resistance. Merenstein highlighted the potential risks associated with antibiotic overuse, including adverse reactions and the emergence of antibiotic-resistant bacteria. The World Health Organization has warned against the uncontrolled spread of antimicrobial resistance, citing its detrimental impact on public health and health care expenditures.

Moving forward, Merenstein emphasized the need for further research into effective treatment strategies for coughs associated with lower respiratory tract infections. "Cough is a common symptom that warrants attention, but the appropriate treatment approach remains unclear," he stated. "Future randomized clinical trials are needed to explore optimal treatment strategies and mitigate the overuse of antibiotics."

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