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See also: Reactive Airways

Source: CMA InfoPoem

Mean duration of cough is 18 days; patients expect about 1 week

Clinical question
Doc, how long will this cough last and when are you gonna give me some antibiotics?

Bottom line
In published studies of patients with cough not treated with antibiotics, the average cough duration is approximately 18 days, although patients anticipate coughing for only 5 days to 7 days. Physicians can educate patients about this discrepancy to reduce inappropriate antibiotic use. (LOE = 1a)

Ebell MH, Lundgren J, Youngpairoj S. How long does a cough last? Comparing patients’ expectations with data from a systematic review of the literature. Ann Fam Med 2013;11(1):5-13.

These authors conducted a mixed methods study in which they compared the duration of cough reported in a systematic review of the published literature with patients’ expectations of cough duration. To establish the literature-base for cough duration in patients not receiving antibiotics, they searched MEDLINE and the reference list of the most recent Cochrane review of antibiotics for acute bronchitis. They obtained their data from observational studies and from the placebo-treated control patients of clinical trials. To obtain data on patients’ expectations, they used random digit dialing to survey residents of Georgia. The researchers identified 19 studies with between 23 and 1230 patients. The mean duration of any cough was 17.8 days (range = 15.3 – 28.6) and for productive cough was 13.9 days (range = 13.3 – 17.4). In contrast, the 493 survey respondents (44% response rate) expected the duration of cough to be from 5 days to 7 days. Patients who were nonwhite, had less education (some college or less), or had previous antibiotic treatment for acute cough illness more often felt that antibiotics were always helpful. One major limitation of the study is that the random patient survey was conducted entirely in the state of Georgia; the culture and beliefs regarding cough duration may vary with regional location.