From the Guidelines
The best treatment for post-inflammatory cough is a trial of inhaled ipratropium, as it may attenuate the cough, according to the American College of Chest Physicians (ACCP) evidence-based clinical practice guidelines 1. When considering treatment options for post-inflammatory cough, it's essential to rule out other common causes of cough, such as bacterial sinusitis, asthma, or gastroesophageal reflux disease.
- Inhaled ipratropium is recommended as a first-line treatment, as it has a fair level of evidence and an intermediate net benefit 1.
- If the cough persists despite the use of inhaled ipratropium, inhaled corticosteroids may be considered, especially if the cough adversely affects the patient's quality of life 1.
- For severe paroxysms of postinfectious cough, a short course of oral corticosteroids, such as 30 to 40 mg of prednisone per day, may be prescribed for a finite period 1.
- Central acting antitussive agents, such as codeine and dextromethorphan, should be considered when other measures fail, as they have an intermediate net benefit and a grade of evidence of E/B 1. It's crucial to note that antibiotics have no role in the treatment of postinfectious cough, as the cause is not bacterial infection 1. The treatment aims to reduce the hypersensitivity of the airways and manage symptoms while the airways heal naturally over time. In addition to pharmacological treatments, home remedies like honey, staying hydrated, using a humidifier, and avoiding irritants can also be effective supportive measures. Overall, the treatment of post-inflammatory cough should be individualized, taking into account the patient's specific needs and circumstances, and guided by the most recent and highest-quality evidence, such as the ACCP guidelines 1.
From the FDA Drug Label
USES Helps loosen phlegm (mucus) and thin bronchial secretions to make coughs more productive. The best treatment for post-inflammatory cough is to use guaifenesin (PO), as it helps loosen phlegm and thin bronchial secretions to make coughs more productive 2.
- Key benefits: loosens phlegm, thins bronchial secretions, makes coughs more productive.
From the Research
Treatment Options for Post-Inflammatory Cough
- The treatment for post-inflammatory cough often involves the use of expectorants, mucolytics, and mucokinetic medications to help loosen and clear mucus from the airways 3.
- Guaifenesin, an expectorant, has been shown to be effective in relieving symptoms of acute upper respiratory tract infections and stable chronic bronchitis by loosening mucus and making coughs more productive 4.
- However, the effectiveness of expectorants like guaifenesin in treating post-inflammatory cough is not well established, and some studies suggest that they may not be effective in treating certain forms of lung disease 3.
Alternative Treatment Approaches
- For patients with chronic cough, treatment options may include anti-inflammatory medications, promotility agents, and neuromodulation therapies to reduce cough hypersensitivity 5.
- Low-dose morphine and other antitussive medications may be effective in reducing cough symptoms in some patients, but their use should be carefully considered due to potential side effects 5, 6.
- In children, the treatment approach may involve identifying and addressing underlying causes of cough, such as foreign body inhalation or persistent bacterial bronchitis, and using antibiotics or other targeted therapies as needed 5.
Pharmacological Interventions
- Bronchodilator medications, such as β agonists and anticholinergics, may be used to help relax airway smooth muscle and improve symptoms of air-flow obstruction in patients with obstructive lung diseases 7.
- Opioid and nonopioid antitussives have been shown to be effective in reducing cough symptoms in some patients, but their use should be carefully considered due to potential side effects and limitations in the evidence base 6.