Why does my cough last 20 days despite antibiotics?

Hello,

Welcome to icliniq.com.

I have read your query.

I understand how frustrating a persistent cough can feel, especially when the reports are not very clear. Let me walk you through this in a simple way.

There are many possible reasons for a cough. It is good that you have already had a chest X-ray done, because that gives us an initial idea and helps narrow things down.

In your X-ray (attachment removed to protect the patient’s identity), there is a suggestion that there may be a small amount of fluid around the left lung. Normally, the lungs are surrounded by a very thin layer that contains a tiny amount of fluid. But when there is irritation, inflammation, or infection, this fluid can increase slightly. Even a small amount can sometimes irritate the lining and lead to a lingering cough.

That said, your X-ray is not very clear. Sometimes what looks like fluid can actually be due to technical factors or minor changes at the base of the lung. So we should be careful not to jump to conclusions based on this alone.

In practice, I would always correlate this with a physical examination using a stethoscope. If there is still any doubt, the best next step is an ultrasound of the chest. It is a simple test and can detect even very small amounts of fluid with much better accuracy.

If fluid is not present, another common cause we consider is bronchial asthma. In asthma, the airways are more sensitive, and this can lead to a prolonged cough, often after a cold. It is quite common, and we usually get clues during examination and confirm it with a test called spirometry.

The reassuring part is that your blood tests are largely normal, which does not point toward anything serious at this stage.

For now:

1. If your cough is dry (no sputum), you can take Levodropropizine syrup 7 ml twice daily for five days.

2. If you notice sputum, please let me know, as treatment would need to be adjusted.

3. You can take the tablet Montelukast (10 mg) and Levocetirizine (5 mg) once daily at bedtime for five days.

4. Steam inhalation twice daily can also help soothe your airways.

I would strongly recommend getting an ultrasound of the chest done next. That will give us a clear answer about whether there is any fluid and help us decide the right direction for further treatment.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.

Hello,

Welcome back to icliniq.com.

I have read your query.

I understand your concern, and at this point, the next step should be simple and practical.

I would recommend that you visit a chest physician for a proper examination. Listening to your chest with a stethoscope often gives us valuable clues whether there is any fluid around the lungs or signs suggesting airway conditions like asthma (a chronic, often lifelong, respiratory condition characterized by airway inflammation, tightening muscles (bronchospasm), and mucus production, causing wheezing, coughing, and chest tightness).

Based on what is found during the examination, your doctor may advise:

1. An ultrasound of the chest, if there is any doubt about fluid.

2. A breathing test called spirometry is performed if asthma is suspected.

From the symptoms you have described, asthma does seem more likely. It commonly presents with a prolonged cough or “cold,” sometimes along with mild chest tightness or shortness of breath. In some cases, there may also be a family history of similar issues.

Different doctors may vary slightly in how they manage treatment, but for respiratory concerns, a chest specialist can offer more focused guidance. That said, the medicines you have been prescribed, especially inhalers and anti-inflammatory treatment, are appropriate and commonly used for asthma, so you are already on the right track.

For now, continue the current treatment and observe how your symptoms respond.

If your cough does not improve within the next one to two weeks, then it would be reasonable to repeat a chest X-ray and consider further evaluation to reassess the situation.

I hope it helps.

Revert in case of any doubts.

Thank you.