Management of cough in adults

Abstract

Cough is highly prevalent as a cumbersome presenting complaint for many patients. The symptom cough is elicited by a myriad of very different respiratory and nonrespiratory diseases. Symptomatic pharmacological treatment is of very limited efficacy. Presently, no new drug for cough in the pipeline has completed phase II development. Therefore, treating cough requires exact diagnosis for causal treatment. Cough is often the first (but not necessarily an early) symptom of life-threatening diseases, such as lung tumours or recurrent pulmonary embolism. Thus, in 2004, the German Respiratory Society published evidence-based guidelines on the management of cough. Acute and chronic cough were defined, and algorithms were provided for diagnostic workup. In 2010, the guidelines were updated (http://leitlinien.net). An abridged english version is also now available [1]. In this review, evidence-based recommendations (mostly weak evidence or consensus) from these guidelines are adapted into learning points.