Senior Health

4/22/2022 | By Howard LeWine, M.D.

Dr. Howard LeWine of Harvard Medical School answers a reader’s question about a persistent cough, including potential causes and common remedies for relief from a cough.

Question:

I am still coughing from a cold that started 10 days ago. I tested twice for COVID-19, both negative. Do I now need an antibiotic to get relief from a cough?

Answer:

Probably not. Most often these upper respiratory infections are caused by common viruses.

Coughs caused by respiratory infections often last two to three weeks. Sometimes the cough can linger for a couple of months. And the persistent cough doesn’t mean you have a bacterial infection. It’s almost always a virus. Antibiotics don’t kill viruses.

The viral infection doesn’t last that entire time. Your immune system usually knocks out the germ within four to five days. The infection is gone. But the irritation of the airways takes time to heal. And this results in a persistent cough.

Coughing is one of our basic defenses against diseases. It expels mucus, germs, and foreign particles to keep them from getting down into the lower airways and lungs. Coughing protects the lungs from infection and inflammation.

But who hasn’t had too much of a good thing? When the hacking becomes relentless, it can keep us up, wear us out and lay us low.

Remedies for relief from a cough

senior man coughing. Photo by Ruslan Huzau Dreamstime. Harvard experts answer a reader’s question about a persistent cough, including potential causes and common remedies for relief from a cough.

If your main reason for the cough is nasal congestion with post-nasal drip, you can get relief from a cough using a decongestant, such as oral pseudoephedrine.

If you choose a nasal decongestant spray, don’t use it for more than three or four days. Your nose quickly gets used to it. Using it too long results in rebound congestion when you stop.

Expectorants and cough suppressants are generally safe when used as directed. Of the ones available “over-the-counter,” products containing dextromethorphan (look for “DM”) seem to help the most to reduce cough severity.

You may do just as well by breathing warm, moist air from a hot shower, a sink filled with very hot water, or a humidifier. Also, drink plenty of fluids to prevent mucus from getting too thick.

Related: Foods that can interfere with medications

For the cough with a scratchy throat, hard candies are soothing and may reduce coughing to provide relief from a cough. They work as well as medicated lozenges.

Some people get relief from a cough with a prescription inhaler similar to what people with asthma use. Doctors most often prescribe inhalers that contain albuterol. Albuterol opens the airways that can become partly closed during a chest cold. For a more persistent coughing, you might also ask your doctor about a corticosteroid inhaler.

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Howard LeWine, M.D.

Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.