These guidelines incorporate the recent advances in chronic cough pathophysiology, diagnosis and treatment. The concept of cough hypersensitivity explains the exquisite sensitivity of patients to external stimuli such a cold air, perfumes, smoke and bleach, providing a firm physical explanation for their symptoms based on vagal afferent hypersensitivity. Different treatable traits exist with cough variant asthma (CVA)/eosinophilic bronchitis responding to anti-inflammatory treatment and non-acid reflux being treated with promotility agents rather the anti-acid drugs. An alternative antitussive strategy is to reduce hypersensitivity by neuromodulation. Low-dose morphine is highly effective in a subset of patients with cough resistant to other treatments. Gabapentin and pregabalin are also advocated, but in clinical experience they are limited by adverse events. Cough suppression therapy when performed by competent practitioners can be highly effective.
Asthma and non-asthmatic eosinophilic bronchitis (NAEB) are among the commonest causes of chronic cough in adults. These guidelines cover the role of non-invasive measurements of airway inflammation, including induced sputum and fractional exhaled nitric oxide, in the evaluation of cough associated with asthma, and the treatment for cough due to asthma or NAEB.
Clinical Practice Guidelines for Diagnosis and Management of Cough produced by the Chinese Thoracic Society
This guideline presents suggestions for diagnosis and treatment based on the best available evidence and identifies gaps in our knowledge as well as areas for future research.
This Chest guideline and systematic review revealed only low-quality evidence to support
how to define psychogenic or habit cough with no validated diagnostic criteria. Low-quality evidence allowed the committee to only suggest therapy for children believed to have psychogenic cough, which might consist of nonpharmacologic trials of hypnosis or suggestion therapy, or combinations of reassurance, counseling, and referral to a psychologist, psychotherapy, and appropriate psychotropic medications.
Overview to the Management of Cough: CHEST Guideline and Expert Panel Report, the purpose being to synthesize current knowledge in a form that will aide clinical decision making for the diagnosis and management of cough across disciplines and also identify gaps in knowledge and treatment options.
The Australian Cough Guidelines is a clinical guideline for the assessment of persistent cough in children and adults and was developed to assist GP’s with a treatment program based on accurate diagnosis and understanding of the causes of cough
British Thoracic Society recommendations for the assessment and management of cough in children
British Thoracic Society Recommendations for the management of cough in adults
American College of Chest Physicians (ACCP) evidence based clinical practice guidelines on the diagnosis and management of cough