COUGH ILLNESS BRONCHITIS - PRINCIPLES OF JUDICIOUS USE OF ANTIMICROBIAL AGENTS

Millions of courses of antibiotics are prescribed for children with ac ute cough illness each year, despite evidence from randomized, placebo -controlled trials that such treatment is not effective. Evidence that children with cough for less than or equal to 10 days should not be t reated with antimicrobial agents is presented. Older children with pro longed cough or those with underlying lung disease may benefit from an timicrobial treatment directed specifically at B pertussis, M pneumoni ae, C pneumoniae, P aeruginosa, or other specific infections. None of the routinely prescribed cephalosporin or amino penicillin antimicrobi als would be effective for these organisms. Noninfectious diagnosis sh ould be sought in children with markedly prolonged cough.