From the Guidelines
For a 22-year-old with a secretive cough producing pus and associated pain, I strongly recommend seeking medical attention promptly as this is not likely just weather-related. This presentation suggests a possible respiratory infection that requires proper diagnosis. The presence of pus in cough (purulent sputum) typically indicates a bacterial infection, possibly bronchitis or pneumonia, which would require antibiotics prescribed by a healthcare provider 1. While waiting for medical care, she can take acetaminophen (Tylenol) 500mg every 6 hours as needed for pain and use honey-lemon tea to soothe throat irritation. Staying hydrated with at least 8 glasses of water daily will help thin secretions.
The pain when coughing could indicate inflammation of the airways or pleura (lining around lungs). Self-medication with antibiotics is not recommended as proper diagnosis is essential to determine the specific pathogen and appropriate treatment 1. Weather changes may exacerbate symptoms but are unlikely to be the primary cause of purulent cough. Rest is important during recovery, and the patient should monitor for worsening symptoms like fever, shortness of breath, or chest pain, which would necessitate urgent medical attention.
Some key points to consider in the diagnosis and management of this patient include:
- The use of C-reactive protein (CRP) to help diagnose pneumonia, as suggested by the guidelines 1
- The importance of not routinely measuring procalcitonin in outpatient adults with acute cough due to suspected pneumonia 1
- The consideration of chest radiography to improve diagnostic accuracy in patients with abnormal vital signs secondary to suspected pneumonia 1
- The recommendation against routine microbiological testing in outpatient adults with acute cough and suspected pneumonia, unless the results may change therapy 1
- The suggestion to use empiric antibiotics as per local and national guidelines when pneumonia is suspected in settings where imaging cannot be obtained 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Symptoms and Possible Causes
- The girl's symptoms include a secretive cough, pain when coughing, and pus, which may indicate a respiratory infection.
- According to 2, chronic cough in adults can be caused by various conditions, including upper airway cough syndrome, gastroesophageal reflux disease, asthma, and nonasthmatic eosinophilic bronchitis.
- However, the girl's age and symptoms do not necessarily suggest a chronic condition, and the cause of her cough may be related to an acute infection.
Treatment Options
- Studies 3 and 4 suggest that azithromycin can be an effective treatment for acute lower respiratory tract infections, including bronchitis and pneumonia.
- Azithromycin has been shown to be as effective as co-amoxiclav in treating acute lower respiratory tract infections 3.
- However, the girl's symptoms and medical history would need to be evaluated by a healthcare professional to determine the best course of treatment.
- According to 5 and 6, amoxicillin-clavulanate and azithromycin are both effective treatments for non-severe respiratory exacerbations in children with bronchiectasis, but the choice of antibiotic may depend on various factors, including the severity of the infection and the patient's medical history.
Next Steps
- The girl should consult a healthcare professional for a proper evaluation and diagnosis of her symptoms.
- The healthcare professional can determine the best course of treatment based on the girl's medical history, symptoms, and test results.
- According to 2, patients with refractory chronic cough may warrant referral to a pulmonologist or otolaryngologist, but this would depend on the severity and duration of the girl's symptoms.