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Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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It is probably inadvisable to use cough suppressants.

  • Results from 13 randomized controlled trials involving 1914 adults and children with symptoms of cough and productive sputum, or with a physician's diagnosis of acute bronchitis, indicate that antibiotics may have beneficial effects in acute bronchitis; however, some of the benefits are slight and need to be balanced against costs, adverse effects, and negative effects on antibiotic resistance pattern. (1)
  • Use of antibiotics (2):
    • antibiotic little benefit if no co-morbidity
    • consider 7 day delayed antibiotic with advice
    • symptom resolution can take 3 weeks
    • consider immediate antibiotics if > 80yr and ONE of:
      • hospitalisation in past year, oral steroids, diabetic, congestive heart failure
      • OR > 65yrs with 2 of above
  • if antibiotic treatment is initiated
    • on the limited occasions when an antibiotic is indicated, a five-day course of amoxicillin (500mg three times a day), oxytetracycline (250-500mg four times a day) or doxycycline (200mg on the first day, then 100mg daily) is a suitable first choice (doses quoted are for adults) (1,3)


  • little evidence to support the use of oral or inhaled beta 2-agonists (e.g. salbutamol) in adults or children with acute cough or bronchitis and no underlying pulmonary disease (3)
    • a Cochrane review found that patients given b2-agonists were more likely to report tremor, shakiness, or nervousness than patients in the control group (3)
  • analgesics and antipyretics may be used where appropriate
  • insufficient evidence to support the use of other over-the-counter cough medicines
  • simplest and cheapest treatment for a cough may be a home remedy such as honey and lemon


(1) Smucny J, Fahey T, Becker L, Glazier R. Antibiotics for acute bronchitis. Cochrane Database Syst Rev. 2004 Oct 18;(4):CD000245. doi: 10.1002/14651858.CD000245.pub2. Update in: Cochrane Database Syst Rev. 2014;3:CD000245. PMID: 15494994.

(2) Smith MP, Lown M, Singh S, Ireland B, Hill AT, Linder JA, Irwin RS; CHEST Expert Cough Panel. Acute Cough Due to Acute Bronchitis in Immunocompetent Adult Outpatients: CHEST Expert Panel Report. Chest. 2020 May;157(5):1256-1265. doi: 10.1016/j.chest.2020.

(3) National Institute for Health and Care Excellence. Cough (Acute): Antimicrobial Prescribing. Vol. 2019. (2019).

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