E-DRUG: Management of Acute Cough in Adults

[Dr Eberhard W Lisse <el@linux.lisse.na>]

E-drug: Management of Acute Cough in Adults
-------------------------------------------

With regards to whether one should give a cough mixture or an
antibiotic for acute (even purulent) cough there was a meta analysis
recently in the BMJ I can look up the reference on monday (the article
is in the hospital) which showed some very interesting stuff in
adults:

Only 9% of the (out) patients presenting with acute cough benefitted
from an antibiotic. This was offset by a further 7% who had side
effects, for the rest it made no difference.  

The older the patients were and the more persistent the cough was the
more the patients benefited from an antibiotics. That makes sense to
me.

Now what was very interesting was that the fulfilment of patient's
expectations had a much better impact than antibiotics, defined as
repeat visits. Which I presume means, if the patients insist on a
cough mixture, give them a cough mixture :-)-O

So the question is, whether cough mixture do what they are supposed to
do, relieve the cough. I seem to remember one article a while back
which tested this in a sleep lab against placebo and it made no
difference. I personally have in my 10 year practice never been
impressed by cough mixtures.

I totally agree that n=2 has no relevance in any discussion of this
kind, however, what I always like to know in these contexts, is what
practitioners do for their own family.

Sometimes this is very surprising :-)-O

el -- 
Dr. Eberhard W. Lisse\         /              Swakopmund State
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