Antibiotics may not be effective against cough caused by Acute Lower Respiratory Tract Infections: Study

The study enrolled 718 adult patients presenting with cough and symptoms consistent with LRTI at primary or urgent care sites across the US. Data collected included demographics, comorbidities, symptoms, and respiratory pathogen testing. Severity of signs/symptoms was reported using diaries and text messages for up to 28 days. Antibiotic use and its effects on symptom duration and severity were analyzed.

The key findings of the study were as follows:

• 29% of patients received antibiotics at baseline, with common prescriptions including amoxicillin-clavulanate, azithromycin, doxycycline, and amoxicillin.

• Antibiotic use did not impact the duration or overall severity of cough, regardless of viral, bacterial, or mixed infections.

• Patients receiving antibiotics were less likely to have a follow-up visit (14.1% vs 8.2%), but were more likely to receive systemic corticosteroids (31.9% vs 4.5%) and albuterol inhalers (22.7% vs 7.6%).

• Patients believed antibiotics would shorten illness duration by nearly 4 days, despite evidence to the contrary.

The study highlights the limited effectiveness of antibiotics in treating acute LRTIs, with no measurable impact on symptom severity or duration. Moreover, patients' unrealistic expectations regarding antibiotic efficacy underscore the importance of antibiotic stewardship efforts. Healthcare providers should prioritize educating patients on the appropriate use of antibiotics and managing expectations for LRTI treatment outcomes.

Antibiotics show no measurable impact on the severity or duration of cough due to acute LRTIs, according to a large prospective study in US primary and urgent care settings. Unrealistic patient expectations regarding antibiotic efficacy highlight the need for targeted antibiotic stewardship interventions to optimize treatment strategies and combat antibiotic resistance.

Reference

Merenstein, D.J., Barrett, B. & Ebell, M.H. Antibiotics Not Associated with Shorter Duration or Reduced Severity of Acute Lower Respiratory Tract Infection. J GEN INTERN MED (2024). https://doi.org/10.1007/s11606-024-08758-y