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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.

Katherine L. O'Brien*, Scott F. Dowell*, Benjamin Schwartz*, S. Michael MarcyDagger , William R. Phillips§, and Michael A. Gerberparallel

From the * Childhood and Respiratory Diseases Branch, DBMD, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Dagger  Kaiser Permanente, Panorama City, California; § Northwest Family Medicine, Seattle, Washington; and parallel  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.

Key words: bronchitis, cough, diagnosis, antimicrobial therapy, antimicrobial resistance, pediatrics.




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