What is the treatment for a wheezy cough?

From the Guidelines

Treatment for a wheezy cough should start with inhaled corticosteroids as first-line treatment, considering the patient's symptoms and medical history, as suggested by the most recent guidelines 1. When managing a wheezy cough, it's essential to consider the underlying cause, which could be asthma, non-asthmatic eosinophilic bronchitis (NAEB), or other conditions.

• The initial approach should involve a thorough medical history and physical examination to determine the cause of the cough, as recommended by the American College of Chest Physicians (ACCP) guidelines 1.
• For patients with chronic cough due to asthma, inhaled corticosteroids should be considered as the first-line treatment, with the option to step up the dose or add a leukotriene inhibitor if the response is incomplete 1.
• Bronchodilators like albuterol (2 puffs every 4-6 hours as needed) can help relax airway muscles and reduce wheezing, while over-the-counter options like guaifenesin (200-400mg every 4 hours) can help thin mucus.
• Home remedies such as staying hydrated with 8-10 glasses of water daily, using a humidifier at night, trying honey (1 teaspoon, not for children under 1 year), and resting with your head elevated can also provide relief.
• It's crucial to seek medical attention if symptoms persist beyond 1-2 weeks, worsen suddenly, or are accompanied by high fever, chest pain, or difficulty breathing, as this could indicate a more serious condition requiring professional evaluation.

From the FDA Drug Label

Patient Package Insert Albuterol Sulfate Inhalation Solution, 0.083%* 2. 5 mg*/3 mL Note: Use only as directed by your physician. More frequent administration or higher doses are not recommended.

The treatment for a wheezy cough is albuterol sulfate inhalation solution, which should be used as directed by a physician. The instructions for use are as follows:

• Remove vial from the foil pouch
• Twist the cap completely off the vial and squeeze the contents into the nebulizer reservoir
• Connect the nebulizer reservoir to the mouthpiece or face mask
• Connect the nebulizer to the compressor
• Sit in a comfortable, upright position and breathe as calmly, deeply and evenly as possible until no more mist is formed in the nebulizer chamber (about 5 to 15 minutes) 2

From the Research

Treatment for Wheezy Cough

The treatment for a wheezy cough, often associated with asthma, involves various approaches to manage symptoms and prevent exacerbations.

• Short-acting beta-agonists (SABAs) provide rapid symptom relief but are recommended for use only as needed due to concerns over increased airway hyper-responsiveness and the risk of fatal or near-fatal asthma with frequent use 3.
• Long-acting beta-agonists (LABAs), such as salmeterol and formoterol, offer more prolonged bronchodilation and are indicated for individuals whose asthma is not well-controlled on moderate doses of inhaled corticosteroids 3.
• The use of combined inhaled corticosteroid-fast acting beta agonist as a reliever is now recommended over SABAs due to safety concerns and poor outcomes associated with SABA monotherapy 4.
• Recent studies have shown that as-needed use of albuterol-budesonide results in a significantly lower risk of severe asthma exacerbation compared to as-needed use of albuterol alone in patients with mild asthma 5.
• The choice between different treatment regimens, such as salmeterol/fluticasone propionate combination versus concurrent beclomethasone and long-acting beta(2)-agonists, can impact asthma control, with combination inhalers potentially offering better control 6.
• Increased exposure to SABAs is associated with a higher risk of severe asthma exacerbations, highlighting the importance of avoiding SABA monotherapy and promoting the use of fast-acting bronchodilators with concomitant inhaled corticosteroids 7.