22/01/2026
About cough and amoxyl.
Cough is a non-specific reaction to irritation anywhere in the respiratory tract from the pharynx to the alveoli.
The most common cause is infection, bacterial or viral.
‘Acute cough’ is defined as cough of < 3 weeks’ duration and if it persists for >8 weeks it becomes a ‘chronic cough’ and subacute if somewhere in between.
As most viral upper respiratory tract infections will have resolved within 3 weeks, any cough lasting >8 weeks or >3 weeks with other symptoms warrants systematic investigation.
The differential diagnosis of cough include:
• Postnasal drip: rhinitis, sinusitis.
• Upper respiratory tract infections: viral or bacterial, causing laryngitis, tracheobronchitis, etc.
• Pressure on the trachea: e.g. from a goitre.
• Lower respiratory tract causes: almost any lung pathology may be associated with cough, in particular asthma (classically a nocturnal [night time] cough), chronic obstructive pulmonary disease (COPD), pneumonia, bronchiectasis, interstitial lung disease and carcinoma.
• Left ventricular failure.
• Drugs: especially angiotensin-converting enzyme (ACE) inhibitors and irritants, e.g. occupational agents.
• Psychogenic/habitual cough.
• Gastro-oesophageal reflux disease (GORD): reflux is a common cause of chronic cough and may not be obvious from symptoms.
The nature of the cough may help in diagnosis.
For example:
• Is there production of sputum?
• How severe is the cough and how disabling has it become to the patient’s life?
• Occupational agents or exposure to dusts that might account for the cough?
• How long has the cough been present?
• Is the cough worse at night? Cough can be the only symptom of asthma.
Just to mention but a few.
How do we treat cough?
Well, we don't. As you have read, cough is but a symptom. We have to address the elephant in the room (underlying cause of cough).
However, there are some cases that require cough suppressants (that's a discussion for another day)
How does then amoxyl come in?
On the Clinician:
As a Clinician, in scenarios where you don't have the facilities to run lab/blood/radiology investigations, you must based on your knowledge and/or experience have a suspicion of underlying bacterial infection that is susceptible to penicillins before prescribing them.
To our dear patients:
Cough in itself is not a disease to be treated, it can be caused by different diseases that require different treatments. Therefore, just because your friend had cough and was given amoxyl and it worked, it doesn't mean the condition that is causing your cough will go away with the same drug. Before you buy that amoxyl, be sure it was prescribed by a qualified health professional.
The Clinician.
