The National Institute for Health and Care Excellence (NICE) has published new antimicrobial prescribing guidance for acute coughs.
Developed in conjunction with Public Health England, the guideline sets out an antimicrobial prescribing strategy for acute cough associated with an upper respiratory tract infection or acute bronchitis in adults, young people, and children.
The NICE guideline evidence notes that acute cough associated with an upper respiratory tract infection or acute bronchitis is usually a self-limiting infection caused by a viral infection, and thus does not generally benefit from antibiotic treatment.
When an antibiotic is deemed appropriate, however, the shortest course that is likely to be effective should be prescribed, which this guideline has determined to be a five-day course.
The first antibiotic choice for acute cough in adults aged over 18 years is doxycycline (200 mg on first day, then 100 mg once a day for the remaining four days), according to the guideline. However, doxycycline should not be given to young women who are pregnant, and the possibility of pregnancy should be considered in young women of childbearing age, the guidance notes. Amoxicillin or erythromycin are preferred in young women who are pregnant.
The guideline’s first choice for antibiotics for acute cough in children and young people aged under 18 years is amoxicillin, with dosing based on specific age bands.