NICE cough guidance urges GPs to reduce antibiotic use

GPs should avoid antibiotics and choose honey, herbal remedies and other over-the-counter medicines as first-line treatments for acute cough, according to draft guidance from NICE and Public Health England (PHE).

GPs urged to cut antibiotic prescriptions for cough
GPs urged to cut antibiotic prescriptions for cough

Patients presenting with coughs that have lasted around three weeks - most likely caused by a cold or flu virus or bronchitis - should not be prescribed antibiotics as they ‘make little difference’ to symptoms, the guidance says.

GPs should encourage patients to self-care using remedies such as honey or cough medicines containing pelargonium, guaifenesin or dextromethorphan - a move that could help reduce GP workload.

The guidance reads: ‘Promoting the role of self-care may help to reduce the amount of antibiotic prescriptions, and repeated or future consultations in general practice.’

Self-care

Professor Mark Baker, director of the centre for guidelines at NICE said: ‘We are keen to highlight that in most cases, antibiotics will not be necessary to treat a cough. We want people to be offered advice on alternatives that may help ease their symptoms.

‘This guideline gives health professionals and patients the information they need to make good choices about the use of antibiotics. We encourage their use only when a person is at risk of further complications.’

Dr Tessa Lewis, GP and chair of the antimicrobial prescribing guideline group said: ‘If someone has a runny nose, sore throat and cough we would expect the cough to settle over 2-3 weeks and antibiotics are not needed.

‘If the cough is getting worse rather than better or the person feels very unwell or breathless then they would need to contact their GP.’

It is also recommended that GPs fully explain the reasons for not giving an antibiotic, and that appropriate self-care advice is given to patients.

This guidance has been developed with PHE as part of a wider programme aiming to tackle antimicrobial resistance.

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