Clinical question
How effective are antibiotics for prolonged (>4 weeks) wet cough in children?
Bottom line
Antibiotics were beneficial in curing the cough (number needed to treat to benefit = 3). Antibiotics also prevented the illness from getting worse, thus avoiding a further course of antibiotics (NNTB = 4). The studies varied in treatment duration (from 7 to 14 days) and the antibiotic used (2 studies used amoxicillin/clavulanic acid; 1 study used erythromycin). There was no clear evidence about whether antibiotics were associated with more side effects. It was not possible to assess long‐term results.
Caveat
The review includes only 3 studies involving 190 participants. The mean age of participants ranged from 21 months to 6 years. The studies excluded children with bronchiectasis or other known underlying respiratory illness.
Context
The most common cause of childhood chronic wet cough is protracted bacterial bronchitis. Timely and effective management of chronic wet or productive cough improves quality of life and clinical outcomes. Current international guidelines suggest a course of antibiotics is the first treatment of choice in the absence of signs or symptoms specific to an alternative diagnosis.
Cochrane Systematic Review
Marchant JM et al. Antibiotics for prolonged wet cough in children. Cochrane Reviews, 2018, Issue 7. Art. No.: CD004822.DOI: 10.1002/14651858. CD004822.pub3. This review contains 3 studies involving 190 participants.
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