INFECTIONS
January 8, 2014

Recovery Time

Worried about that persistent cough? Consider patience, not medicine. Even doctors underestimate how long it can take to get over a cold.

Children's illnesses are hard on parents. All winter long children bring home colds, coughs, sore throats, and earaches, often in quick succession, and share them with their families.

It can seem as though the runny noses, watery eyes and bronchial coughs never go away, as viruses are passed along from family member to family member.

When kids' noses keep running and their coughs are heard throughout the house — parents start to think about heading to the doctor's office to make sure nothing more serious is going on and to get some relief.

Many are hoping their doctors will prescribe antibiotics which will finally clear up whatever is ailing their child.

All in all, the researchers found that common respiratory symptoms persist longer than anticipated and often longer than physicians tell their patient’s families to expect.

If more parents had a clearer idea of just how long it takes to recover from a cold or cough, however, they might save themselves the trip and the trouble.

A recent literature review updates our assumptions about how fast cold symptoms should go away and may provide some guidance to families for the winter season.

Even simple colds last longer than we tend to expect, the researchers found after reviewing dozens of studies of coughs, earaches, sore throats, and general upper respiratory infections. So the first thing to keep in mind is that the duration of illness is not a sign of its severity or the need to seek medical treatment.

For example, in their review of 10 studies of children with earaches, they found that in half of children, symptoms resolved after three days, and 90% showed improvement by 7-8 days. Though the children in most of the studies received acetaminophen or other treatment for pain and fever, they did not receive antibiotics unless there was drainage from the ear.

The review of over 10,000 studies also revealed that:

  • Croup, which causes a harsh, barking cough, typically lasted two to three days.
  • Bronchiolitis, an inflammation of the small airways, averaged eight to 15 days.
  • Sore throats lasted anywhere from two to 7 days and, again, most studies did not report treatment with antibiotics.

    A doctor may do a strep screen or throat culture to determine whether the cause is bacteria or viral, but parents, even if given a prescription for antibiotics, should wait to start them until it is clear from the throat culture that there is a bacterial infection.
  • It is perfectly normal for coughs to last for a long time, anywhere from one to 25 days, (though a majority of children with a cough were better by 21 days). Non-specific respiratory symptoms, such as runny nose, watery eyes, and congestion lasted for four to 16 days.

All in all, common respiratory symptoms persist longer than anticipated and often longer than physicians tell their patient’s families to expect, the researchers found. This is something for parents to keep in mind as they consider whether or not to head to the doctor's office.

The researchers, from Oregon Health and Science University and the University of Oxford (UK), hope physicians will use this data to counsel parents appropriately about how long they should expect to see signs of illness and whether to begin antibiotic treatment.

If children’s symptoms worsen, they have difficulty breathing or swallowing, they develop a high fever, listlessness or excessive sleepiness, or they have another concerning change in their health status, families should consult a medical provider.

The study is openly accessible and published in BMJ.

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