Cough in India often treated with unnecessary antibiotics: Study

A new study published in the Journal of the Association of Physicians of India has found that cough, one of the most common reasons for outpatient visits in India, continues to be poorly classified and is often treated with unnecessary antibiotics. The research, conducted by Kenvue, the maker of Benadryl, analysed electronic medical records of more than 22 lakh patients and highlighted serious gaps in cough management in the country, a PTI report stated.

Lack of categorisation in diagnosis

The analysis showed that most cough cases were recorded as “unspecified,” meaning doctors did not classify them as productive, nonproductive, or allergic. According to the study, 71.04 per cent of adult patients and 66.42 per cent of elderly patients fell into this category. This lack of classification limits symptom-specific treatment and results in prescribing habits not backed by medical evidence.

Overuse of antibiotics

The study revealed that more than half of all patients were prescribed antibiotics irrespective of cough type. Among adults, 60.3 per cent with productive cough and 53.1 per cent with nonproductive cough received antibiotics. In the elderly group, 62 per cent with productive cough and 52.3 per cent with nonproductive cough were given antibiotics. Azithromycin was the most used antibiotic, followed by cefpodoxime, while fixed-dose combinations like amoxicillin with clavulanic acid were also common.

Concerns over irrational drug use

The findings raised concerns about the frequent use of multi-ingredient cough formulations and irrational prescribing practices. The report warned that such practices increase healthcare costs, lead to avoidable side-effects, and worsen the global problem of antimicrobial resistance.

Experts call for evidence-based practices

Dr Agam Vora, General Secretary of the Association of Physicians of India (API), told PTI, "The study highlights that cough, despite being one of the most common health complaints, continues to be treated in ways that lack scientific consistency. This undermines patient care, prolongs symptoms, and exposes people to unnecessary medicines.

"The findings advocate for rational prescribing practices, particularly in reducing the overuse of antibiotics, and call for better documentation and tailored treatment approaches."

Vora termed the overuse of antibiotics in cough treatment alarming, warning that they are often prescribed when not needed, fuelling antimicrobial resistance. "This study highlights that India must urgently align everyday clinical practice with evidence-based recommendations, prioritising rational prescribing and strict categorisation. Only then can we safeguard both individual patients and the healthcare system at large," he added.

New initiatives to improve cough care

Dr Harshad Malve, Medical Head, Self Care and Operations, Kenvue, said, "The study highlights the need for an urgent structured approach to cough management in India.

(Inputs from PTI)