By Alex Therrien
Honey and over-the-counter medicines should be the first line of treatment for most people with coughs, new guidelines recommend.
Antibiotics should rarely be prescribed by doctors for coughs because in most cases they do little to improve symptoms, health officials say.
Most of the time a cough will improve on its own within two to three weeks.
The new recommendations for doctors are intended to help tackle the problem of antibiotic resistance.
Overusing antibiotics is making infections harder to treat, by creating drug-resistant superbugs.
A hot drink with honey – and often with lemon and ginger as well – is a well-known home remedy for coughs and a sore throat.
Now new proposed guidelines from the National Institute for Health and Care Excellence (NICE) and Public Health England (PHE) say there is some limited evidence that it can help improve cough symptoms.
Cough medicines containing pelargonium, guaifenesin or dextromethorphan might also be beneficial, they say.
Patients are being advised to use these treatments and wait for symptoms to improve on their own, before going to a GP.
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Most coughs are caused by viruses, which cannot be treated by antibiotics and will clear up on their own.
Yet despite this, research has previously found that 48% of UK GP practices have prescribed antibiotics for a cough or bronchitis.
Dr Susan Hopkins, a deputy director at PHE, said: “Antibiotic resistance is a huge problem, and we need to take action now to reduce antibiotic use…
“These new guidelines will support GPs to reduce antibiotic prescriptions and we encourage patients to take their GP’s advice about self-care.”
However, the guidelines recommend that antibiotics may be necessary for a cough when it is part of a more serious underlying illness, or when a person is at risk of further complications, such as those with chronic health conditions or weakened immune systems.
Honey is not recommended for children under the age of one because it occasionally contains bacteria that can cause infant botulism.
Dr Tessa Lewis, GP and chair of the antimicrobial prescribing guideline group, said: “People can check their symptoms on NHS Choices or NHS Direct Wales or ask their pharmacist for advice.
“If the cough is getting worse rather than better, or the person feels very unwell or breathless, then they would need to contact their GP.”
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Analysis: Antibiotic apocalypse
The draft recommendations are part of a raft of new antibiotic prescribing guidelines being developed jointly by PHE and NICE.
England’s chief medical officer, Prof Dame Sally Davies, has previously warned of a “post-antibiotic apocalypse”.
If the drugs fail, infections will become harder to treat and common medical procedures such as cancer treatments and transplants would be too risky, she said.
The consultation on the new guidelines closes on 20 September.