The majority of adults with a short duration of cough from an acute respiratory tract infection have a viral rather than a bacterial infection. Patients often underestimate the typical cough duration from an infectious illness, and when cough does not resolve within their expected time frame, may request antibiotics. The average duration of cough (not treated with antibiotics) is around 18 days, though patients only expect to cough for 5 to 7 days. Use of immediate or delayed antibiotics does not change clinical outcomes compared to no antibiotics in these situations. On the other hand, the harms of over-prescribing antibiotics include medication costs, adverse reactions, and the possibility of inducing bacterial resistance to antibiotics. Physicians should educate patients about the expected duration of cough and the consequences of inappropriate antibiotic use in acute respiratory tract infections.
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