By Howard LeWine, M.D., Tribune Media Services
The Medicine Cabinet
3:30 PM EDT, September 27, 2013
Q: I've been coughing for more than a week. It started with a head cold and has moved down into my chest. Do I need an antibiotic?
A: Like you, many people think that a cough related to a chest cold should last a week or less. And when it continues beyond five or six days, the common conclusion is: "I need an antibiotic."
Not so! Coughs caused by respiratory infections most often last two to three weeks. Sometimes the cough can linger for a couple of months. But the persistent cough doesn't mean you have a bacterial infection. It's almost always a virus. Antibiotics don't kill viruses.
The viral infection doesn't last that entire time. Your immune system usually knocks out the germ within four to five days. The infection is gone, but the irritation of the airways takes time to heal. And this makes the cough persist.
Coughing is one of our basic defenses against diseases. It expels mucus, germs and foreign particles, preventing them from getting down into the lower airways and lungs. Coughing protects the lungs from infection and inflammation.
But who hasn't had too much of a good thing? When the hacking becomes relentless, it can keep us up, wear us out and lay us low.
If the main reason for the cough is nasal congestion with post-nasal drip, you can get relief from a decongestant, such as oral pseudoephedrine.
If you choose a nasal decongestant spray, don't use it for more than three or four days. Your nose quickly gets used to it. Using it too long results in rebound congestion when you stop.
Expectorants and cough suppressants are generally safe when used as directed. But they actually don't help much for coughs caused by chest colds. You will do just as well by breathing warm, moist air from a hot shower, a sink filled with very hot water, or a humidifier. Also, drink plenty of fluids to prevent mucus from getting too thick.
For the cough with a scratchy throat, hard candies are soothing and may reduce coughing. They work as well as medicated lozenges.
Some people get relief with a prescription inhaler similar to what people with asthma use. Doctors most often prescribe inhalers that contain albuterol. Albuterol opens the airways that can become partly closed during a chest cold. For more persistent coughing, you might also ask your doctor about a corticosteroid inhaler.
(Howard LeWine, M.D., is a practicing internist at Brigham and Women's Hospital, Boston, Mass., and Chief Medical Editor of Internet Publishing at Harvard Health Publications, Harvard Medical School.)
(For additional consumer health information, please visit http://www.health.harvard.edu.)
Copyright © 2013, Tribune Media Services