Antibiotic little benefit if no co-morbidity. Symptom resolution can take 3 weeks.

Acute cough with upper respiratory tract infection: no antibiotic.

Acute bronchitis: no routine antibiotic.

Acute cough and higher risk of complications (at face-to-face examination): immediate or backup antibiotic.

Acute cough and systemically very unwell (at face to face examination): immediate antibiotic.

 

Higher risk of complications includes people with pre-existing comorbidity; young children born prematurely; people over 65 with 2 or more of, or over 80 with 1 or more of: hospitalisation in previous year, type 1 or 2 diabetes, history of congestive heart failure, current use of oral corticosteroids.

Drug details

Drug

First choice:

Amoxicillin

Dosage

500mg

Duration

3 times a day 5 days

Child Dose

Drug

Penicillin allergy or alternative required:

Doxycycline

Dosage

200mg

then 100mg

Duration

on day 1

once daily for 4 further days.

Use clarithromycin for 5 days in children under 12 with penicillin allergy.

Child Dose

Drug

OR (penicillin allergy in pregnancy)

Erythromycin

Dosage

250-500mg

or 500-1000mg

Duration

4 times a day

twice daily 5 days

Editorial Information

Last reviewed: 18/05/2022

Next review date: 18/05/2025

Author(s): NHS Lanarkshire Antimicrobial Management Committee, Dr Dundas, Dr Hylands, S McCormick, Heather Boyle.

Version: V1

Approved By: AMC; ADTC

Reviewer name(s): NHS Lanarkshire Antimicrobial Management Committee.

Document Id: June 2022