Be patient: Study says coughs often take nearly three weeks to clear up
One of the reasons I hate catching colds is because my symptoms always linger longer than most people, or so it seems.
More than two weeks ago, when every American seemed to have the flu or a severe cold, I was dodging sneezing, wheezing colleagues like they had the plague and washing my hands at every opportunity, but alas, I felt one coming on.
I made sure to get plenty of sleep, drink lots of water, eat well and exercise only moderately and managed to keep my pre-cold, perhaps a mini-cold, from turning into a full-fledged one.
But as I write this, a minor but annoying cough persists.
I’m accepting it better than most winters after reading a new study by researchers in Georgia and published in the Annals of Family Medicine this month. The study showed that people expect coughs to clear up in a week, when, in reality, it usually takes nearly three weeks to clear up.
And while that was news to me, the point of the study is that people have unrealistic expectations for relief and often go to doctors pushing them for antibiotics, which not only won’t speed their recovery but increase expense and fuel resistance to the drugs.
“We’re not trying to discourage people from getting care if they feel they need it, but at the same time, we want to give them the confidence to give themselves care in situations when it’s appropriate,” lead study author Dr. Mark Ebell of the University of Georgia in Athens says in a release about the study.
Study of studies
Ebell’s study wasn’t one of those minuscule studies of a couple of dozen people followed for a few weeks.
He and his colleagues first took a telephone survey of nearly 500 adults in Georgia about how long they would expect a cough to last based on a hypothetical situation. Generally, people expected seven to nine days.
Then they reviewed 19 previous studies on severe coughs that recorded how long the condition actually lasted. In those studies, it took a cough, on average, 17.8 days to subside.
According to the researchers, about 50 percent of patients diagnosed with an acute cough in 2006 were prescribed an antibiotic, even though most respiratory infections are caused by viruses. Antibiotics only affect bacteria.
Ebell said there are situations when people should go to a doctor for a cough, such as when they’re bringing up blood or are short of breath. But in most cases, just let the cough run its course and treat the symptom.
Spread the word
Dr. Matt Blue, an emergency room doctor at Roper Hospital, was glad to hear the message was getting out about people needing more patience with a cough.
“Almost everybody gets an upper respiratory infection, or a cold, a few times a year. Throw in a pretty wicked fall allergy season in the Lowcountry and then the spring pollen season and a lot of people find themselves at the doctor needlessly several times a year,” says Blue.
Blue often hears patients say they want to nip an illness in the bud and ask for an antibiotic. “It drives me crazy on a personal level but from a public health standpoint is driving up the cost of health care and breeding drug-resistant bacteria.”
Blue says a rule of thumb should be that healthy individuals between (ages) 2 and 62 can expect their symptoms to last five to 15 days.
The exceptions, he adds, are people with legitimate or long-term underlying sinus disease or lung disease, are immune-compromised, or “extremes of age”(very young or very old).
When he is personally affected, Blue allows himself to go up to two weeks with upper respiratory symptoms, though he usually feels better within three to five days.
“This is coincidentally about the length of the Z-Pak, which is everybody’s favorite yet most overprescribed antibiotic,” says Blue.
But it’s understandable that coughs not only are irritating, but stand in the way of valuable sleep.
Blue says over-the-counter and prescription medications, whether in the form of syrup or a tablet, work by two mechanisms.
“There are decongestants, which decrease the amount of phlegm or mucus present, and there are cough suppressants. A lot of the over-the-counter medications are a combination of the two,” says Blue. “These allow people to cough less frequently and when they do, their cough is more productive, allowing them to clear their airways more efficiently.
“Prescription-strength cough medications usually have a narcotic mixed in and should be reserved for persistent and debilitating cough as frequently seen in those with influenza and pertussis (whooping cough),” he says, adding that the use of steroids and inhalers should be at the discretion of a patient’s health care provider.
Blue says recovering from an upper respiratory infection, such as a head cold and most cases of bronchitis, usually takes one to two weeks. Viral infections damage the lining of the airways and, “much like an abrasion on your knee, just take time to heal.”