QUANTITATIVE SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS COMPARING ANTIBIOTIC WITH PLACEBO FOR ACUTE COUGH IN ADULTS

Objectives: To assess whether antibiotic treatment for acute cough is effective and to measure the side effects of such treatment Design: Qu antitative systematic review of randomised placebo controlled trials. Data sources: Nine trials (8 published, 1 unpublished) retrieved from a systematic search (electronic databases, contact with authors, conta ct with drug manufacturers, reference lists); no restriction on langua ge. Main outcome measures: Proportion of subjects with productive coug h at follow up (7-11 days after consultation with general practitioner ); proportion of subjects who had not improved clinically at follow up ; proportion of subjects who reported side effects from taking antibio tic or placebo. Results: Eight trials contributed to the meta-analysis . Resolution of cough was not affected by antibiotic treatment (relati ve risk 0.85 (95% confidence interval 0.73 to 1.00)), neither was clin ical improvement at re-examination (relative risk 0.62 (0.36 to 1.09)) . The side effects of antibiotic were more common in the antibiotic gr oup when compared to placebo (relative risk 1.51 (0.86 to 2.64)). Conc lusions: Treatment with antibiotic does not affect the resolution of c ough or alter the course of illness. The benefits of antibiotic treatm ent are marginal for most patients with acute cough and may be outweig hed by the side effects of treatment.