PEDIATRICS Vol. 101 No. 1 Supplement January 1998, pp. 178-181
Cough Illness/Bronchitis
Principles of Judicious Use of
Antimicrobial Agents
Received Aug 8, 1997; accepted Sep 11, 1997.
,
From the * Childhood and Respiratory Diseases Branch, DBMD,
National Center for Infectious Diseases, Centers for Disease Control
and Prevention, Atlanta, Georgia; Kaiser Permanente, Panorama City,
California; § Northwest Family Medicine, Seattle, Washington; and
Connecticut Children's Medical Center, Hartford, Connecticut.
Millions of courses of antibiotics are prescribed for children with
acute cough illness each year, despite evidence from randomized, placebo-controlled trials that such treatment is not effective. Evidence that children with cough for 
10 days should not be treated with antimicrobial agents is presented. Older children with prolonged cough or those with underlying lung disease may benefit from
antimicrobial treatment directed specifically at B pertussis, M
pneumoniae, C pneumoniae, P aeruginosa, or other specific
infections. None of the routinely prescribed cephalosporin or amino
penicillin antimicrobials would be effective for these organisms.
Noninfectious diagnosis should be sought in children with markedly
prolonged cough.
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