Cough antibiotics: Cough, one of the most common reasons for OPD visits in India, remains poorly classified and often incorrectly treated, with heavy reliance on antibiotics and fixed-dose combinations (FDCs), according to a study published in the Journal of the Association of Physicians of India.
The analysis, led by Kenvue (the makers of Benadryl), using electronic medical records from over 22 lakh patients, found that most cases were recorded as “unspecified,” with no distinction between productive, non-productive, or allergic coughs. In adults, 71.04% were not categorised; among the elderly, 66.42% were similarly unspecified, gaps that the authors say drive habit-based rather than evidence-based treatment.
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Antibiotic use was widespread, regardless of the type of cough. Among adults, 60.3% with productive cough and 53.1% with non-productive cough received antibiotics; in the elderly, the figures were 62% and 52.3%, respectively. Azithromycin was the most frequently prescribed antibiotic, followed by cefpodoxime, while FDCs such as amoxicillin-clavulanic acid were commonly used.
The study also highlighted the persistent use of multi-ingredient cough syrups. These practices, it warned, raise costs, increase side effects and contribute to antimicrobial resistance.
“This undermines patient care, prolongs symptoms, and exposes people to unnecessary medicines,” said Agam Vora, General Secretary of the Association of Physicians of India, calling the overuse of antibiotics in cough management “alarming.” He urged stricter categorisation, better documentation and tailored therapy to align daily practice with evidence-based recommendations.
The authors conclude that improving documentation, reducing unwarranted antibiotics and selecting symptom-specific treatments are critical to better outcomes and to curbing the growing threat of drug resistance in routine cough care.
