MODERN APPROACHES TO THE TREATMENT OF COUGH: ANTIBIOTIC THERAPY AND IMMUNOMODULATORS

Abstract

Background: Cough is one of the most common clinical symptoms encountered in pediatric and adult populations. It is often a manifestation of underlying respiratory infections or inflammatory conditions. While traditional management has focused on symptomatic relief, emerging approaches using targeted antibiotic therapy and immunomodulators aim to address the underlying pathophysiological mechanisms. Objective: This study reviews and evaluates the efficacy of antibiotic therapy and immunomodulatory agents as modern treatment modalities for cough, with an emphasis on their roles in managing bacterial infections and modulating immune responses. Methods: A prospective, multicenter observational study was conducted involving 450 patients presenting with acute and subacute cough. Participants were stratified into two treatment arms: one receiving antibiotic therapy tailored to microbial culture and sensitivity (n = 225), and the other receiving immunomodulatory treatment (n = 225) based on specific inflammatory marker profiles. Clinical parameters—including cough severity (using a validated cough scoring system), duration, resolution rates, and adverse effects—were recorded at baseline and during follow-up at 7, 14, and 28 days. Results: The antibiotic therapy group demonstrated rapid symptom resolution in patients with confirmed bacterial infections, with a median cough duration of 5 days compared to 8 days in patients without targeted antibiotic therapy (p < 0.001). The immunomodulator group exhibited significant improvements in cough severity scores, with a notable reduction in pro-inflammatory cytokines (IL-6 and TNF-α) and a more balanced immune profile, translating into lower complication rates. Multivariate logistic regression identified both targeted antibiotic therapy and immunomodulation as independent predictors for faster clinical resolution (adjusted OR 0.55, 95% CI 0.40–0.75, p < 0.001 and adjusted OR 0.60, 95% CI 0.42–0.86, p = 0.005, respectively). Conclusions: Modern management of cough using antibiotic therapy—when guided by microbiological evidence—and immunomodulators offers a promising dual approach. These strategies not only reduce the duration and severity of cough but also address the underlying inflammatory and infectious processes. Integration of these modalities into clinical practice could enhance patient outcomes and reduce healthcare burdens.