Can't shake that cough? Want to run to the doctor and ask for an antibiotic? Wait it out, says Dr. Mark Ebell. It's not antibiotics that chase away chest colds. It's time.
Dr. Ebell conducted a simple study. The University of Georgia professor asked 500 Georgia residents how long they think a cough lasts. He then compared their answers to data that showed how long a cough actually lasts. The gap was sizable. While respondents said a cough lasts between five and nine days, published research shows an average duration of 17.8 days, ranging from 15.3 to 28.6 days.
Somewhere between day seven and day 17.8, many people head to the doctor for antibiotics they don't need. That's why Dr. Ebell says he commissioned the study.
"We're impatient in this country. We want things hot and now and fast," he says.
For chest colds, Ebell says antibiotics should be taken by those at the extremes of age—the very young and very old—as well as those with chronic lung disease, shortness of breath, significant wheezing, or tightness in their chest, or by those who are coughing up blood or brown-or-rust-colored sputum. He adds that if you or a loved one feels so miserable that you become worried, see a doctor.
Those who demand antibiotics for cold or flu ignore a basic law of medicine. Antibiotics only cure bacterial illness. They cannot cure viral illnesses such as colds, flu, most coughs, bronchitis, runny noses, and sore throats not caused by strep.
Why do doctors prescribe them? Uncertainty, time pressure, financial pressure, and action bias, which is an affliction suffered by both doctor and patient. Action bias states that when faced with a problem, a person will choose action over inaction in order to avoid regret.
It's action bias that leads to patients and their insurers spending more money on antibiotics they don't need, thus driving up costs within what is already the most expensive health system in the world.
There are side effects too. Antibiotics can leave patients susceptible to nausea, vomiting, and diarrhea. An antibiotic searching for bacteria in your lungs will hunt in your stomach, too, where it might kill the "good bacteria" in your digestive system. Hello, bathroom.
There are societal implications as well. Bacteria can become resistant to antibiotics, and because humans shed bacteria constantly, that resistance can be passed to those around you, making them more resistant to antibiotics.
Ebell is sympathetic to patients who want to feel better, especially those without sick days who are desperate to work. He suggests a regimen of over-the-counter medicines, home remedies, and rest. "Do all those things your mom told you to do," he says.
Joe Donatelli is a freelance journalist. He can be reached at joedonatelli.com.