Abstract
Introduction:
Acute cough is a common presentation in general practice. The indications for antibiotic prescription are debated.
Methods:
Prospective observational study of adults consulting General Practitioners with acute cough.
Subjects:
Over 26 months, 377 visits were made by the research nurse to 12 family practices in the UK using a randomised schedule. All consenting patients (17 yrs or older) seen with acute cough were recruited. A symptom questionnaire was obtained.
Results:
162 patients were recruited (64 male, median age 49.5 range 17–88 yrs). Co-morbidity with asthma was reported by 25%. Only 10% had a temperature of >37.0°C. Sputum production was reported by 90%. The median (range) duration of cough was 7 (1–14) days. The following symptoms were reported by patients: breathlessness (81%), wheeze (79%) sweating (51%), chest pain (48%) haemoptysis (8%). Antibiotics were prescribed to 63%. The age of those prescribed antibiotic was greater than that of those not (52.2 vs. 45.7 yrs, p = 0.04). Antibiotics were prescribed to a higher proportion of patients with breathlessness than without (69% vs. 38%, p =0.002), other symptoms were not predictive of antibiotics. There was a non-significant tendency for a higher prescribing rate in those with reporting productive cough (65% vs. 47%) p = 0.17, and to those reporting purulent sputum (67% vs. 50%) p = 0.15. Antibiotics were prescribed to a higher percentage of those with a fever (87%) than those without (59%), p = 0.04 The duration of cough, sex, smoking status and co-morbidity were not associated with an antibiotic prescription.
Conclusions:
Many patients presenting with acute cough are prescribed antibiotics; factors predicting the issue of a prescription include age, breathlessness and fever.
Conflict of interest and funding
Conflict of interest: None. Funding: Department of Health UK.
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Thomas, M., John, R., Hay, A. et al. ABS82: Symptom pattern and antibiotic prescription in patients with acute cough. Prim Care Respir J 15, 208 (2006). https://doi.org/10.1016/j.pcrj.2006.04.174
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DOI: https://doi.org/10.1016/j.pcrj.2006.04.174