Time, Not Antibiotics, Best Rx for Chest Cold

June 21, 2005 -- Antibiotics don't help a chest cold much -- even if you're coughing up icky green gunk, a new study shows.

The new findings don't apply to people with underlying lung disease. These patients probably do benefit from antibiotics. But the rest of us do not, find Paul Little, MD, professor of medicine at England's University of Southampton, and colleagues.

Little's team studied some 800 otherwise healthy people, aged 3 years and older, seeing a doctor for a lower respiratory infection. Doctors often call this bronchitis. Most of us know it as a chest cold.

The researchers gave some of the patients antibiotics right away. Others didn't get antibiotics at all. A third group got a prescription for antibiotics, but it was left in a box at the reception desk. They could get the prescription at any time but were advised to wait 14 days.

The bottom line: Nobody got better much faster than anybody else did. On average, patients already had a cough for nine days before they saw a doctor. It took about 12 more days for patients' coughs to get completely better -- although one in four patients had a cough lasting 17 more days or longer. The findings appear in the June 22/29 issue of The Journal of the American Medical Association.

"Doctors have unfortunately been doling out antibiotics believing they will help -- but antibiotics do not seem to be the answer," Little tells WebMD. "Antibiotics may make a difference of a day in an illness lasting three weeks. I tell patients, 'In your case, antibiotics will probably not make a difference -- and you have to suffer their side effects if you take them.'"

Chest Colds Linger Longer

Modern medical science has made huge strides in understanding and treating a wide variety of diseases. Yet surprisingly little is known about the common illnesses that plague us.

That's why Little's study is so important, says Mark H. Ebell, MD, deputy editor of American Family Physician and associate professor at Michigan State University. He says the findings aren't just a surprise to patients -- they're a surprise to doctors, too.

For example, Ebell notes, doctors generally thought the cough from a chest cold lasted about a week. Surprisingly, Little's team finds that these coughs last for about three weeks -- and often last a month. And it's also a surprise to many doctors that antibiotics really don't help otherwise healthy patients with chest colds.

"I hope this will educate doctors about the limits of antibiotics for treating cough," Ebell tells WebMD. "It is very hard for doctors to learn the limits of their own informal observations in practice and to lean that sometimes the studies are right and they are wrong."