From the Guidelines
A chronic cough is typically defined as one that persists for more than 8 weeks in adults, according to the most recent and highest quality study 1. This definition is crucial for diagnosis and treatment planning. The timeline for a chronic cough can vary, but generally, a cough lasting less than 3 weeks is considered acute, while one lasting 3-8 weeks is classified as subacute.
Key Points to Consider
- The definition of a chronic cough is based on a consensus statement from the American College of Chest Physicians 1.
- The duration of a cough is a critical factor in determining the underlying cause and guiding treatment.
- Common causes of chronic cough include postnasal drip syndrome, asthma, gastroesophageal reflux disease (GERD), and chronic bronchitis.
- Treatment typically follows a stepwise approach, starting with addressing the most likely cause based on associated symptoms.
Treatment Approach
- For postnasal drip, first-generation antihistamines like chlorpheniramine may be prescribed 1.
- For asthma, inhaled corticosteroids such as fluticasone may be used 1.
- GERD-related cough might require proton pump inhibitors like omeprazole 1.
- If the cough persists despite targeted therapy for 4-6 weeks, reevaluation and consideration of alternative diagnoses is necessary 1.
Importance of Accurate Diagnosis
- Accurate diagnosis is essential to guide treatment and improve patient outcomes 1.
- A thorough assessment process, including objective testing and therapeutic trials, is recommended 1. In summary, a chronic cough is defined as one that persists for more than 8 weeks in adults, and the treatment approach should be guided by the underlying cause and associated symptoms, as recommended by the most recent and highest quality study 1.
From the Research
Definition and Duration of Chronic Cough
- A chronic cough is defined as a cough lasting longer than 8 weeks in adults 2, 3, 4, 5.
- In children, a cough lasting longer than 4 weeks is considered chronic 2, 4.
Typical Timeline for Chronic Cough
- The duration of chronic cough can vary, with some patients experiencing cough for many years 5.
- Chronic cough can be caused by various conditions, including upper airway cough syndrome, asthma, gastroesophageal reflux disease, and nonasthmatic eosinophilic bronchitis 2, 6, 3, 4.
- The timeline for chronic cough can be influenced by the underlying cause, with some conditions resolving after targeted treatment, while others may persist despite optimal treatment 5.
Evaluation and Management of Chronic Cough
- Initial evaluation of chronic cough should include a focused history and physical examination, as well as chest radiography and pulmonary function testing 2, 3, 4.
- Empiric treatment should be initiated based on the suspected underlying cause, and referral to a specialist may be indicated if the cause is not identified or if symptoms persist despite treatment 2, 4, 5.