Widely prescribed antibiotic amoxicillin is useless at treating coughs and may be harmful
23:45 GMT, 18 December 2012
Amoxicillin does nothing to help treat coughs and could be harmful if used when it is not needed, researchers claim
Commonly prescribed antibiotic amoxicillin does nothing to help treat coughs and could be harmful if used when it is not needed, warn experts.
Amoxicillin is given to people with respiratory infections, including coughs, and treats bacterial infections of the chest, urine or ear, and dental abscesses.
But researchers say taking the prescription drug to treat infection may do more harm than good, leading to side effects such as diarrhoea, rash, vomiting and the development of resistance.
Amoxicillin is commonly used to treat coughs accompanied by lower respiratory tract symptoms (LTRI), and although viruses are believed to cause most of these infections, whether or not antibiotics are effective in treating them is still hotly debated.
In the study, 2,061 adults with acute uncomplicated LRTI from primary care practices in 12 European countries – England, Wales, Netherlands, Belgium, Germany, Sweden, France, Italy, Spain, Poland, Slovenia, and Slovakia – were randomly assigned to receive either amoxicillin or a placebo three times a day for seven days.
Doctors assessed symptoms at the start of the study and the participants completed a daily symptom diary.
Results showed there was little difference in severity or duration of symptoms reported between the two groups, even among older patients aged over 60 where antibiotics appeared to have a very limited effect.
More patients in the placebo group experienced new or worsening symptoms, 30 people needed to be treated to prevent one case of worsening symptoms, and just two patients in the placebo group and one in the antibiotic group required hospitalisation.
Side effects include diarrhoea, rash, vomiting and the development of resistance
But The Lancet study also revealed patients taking antibiotics reported significantly more side effects – including nausea, rash, and diarrhoea – than those given the placebo.
Professor Paul Little, of the University of Southampton, said: 'Patients given amoxicillin don't recover much quicker or have significantly fewer symptoms.
'Using amoxicillin to treat respiratory infections in patients not suspected of having pneumonia is not likely to help and could be harmful.
'Overuse of antibiotics, which is dominated by primary care prescribing, particularly when they are ineffective, can lead to side effects – such as diarrhoea, rash, vomiting – and the development of resistance.'
Commenting on the report, Dr Philipp Schuetz, from the Kantonsspital Aarau in Switzerland, said: 'This is convincing data that should encourage physicians in primary care to refrain from antibiotic treatment in low-risk patients in whom pneumonia is not suspected.
'Whether this one size- fits-all approach can be further improved remains to be seen.
'Guidance from measurements of specific blood biomarkers of bacterial infection might help to identify the few individuals who will benefit from antibiotics despite the apparent absence of pneumonia and avoid the toxic effects and costs of those drugs and the development of resistance in other patients.'