Treatment Of Unexplained Chronic Cough
Publication Date: January 1, 2016
Last Updated: March 14, 2022
Recommendations and Suggestions
In adult patients with chronic cough, we suggest that unexplained chronic cough be defined as a cough that persists longer than 8 weeks and remains unexplained after investigation, and that supervised therapeutic trial(s) be conducted according to published best-practice guidelines. (, )
(Ungraded Consensus-Based Statement)
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In adult patients with chronic cough, we suggest that patients with chronic cough undergo a guideline/protocol based assessment process that includes objective testing for bronchial hyperresponsiveness and eosinophilic bronchitis, or a therapeutic corticosteroid trial.
(Ungraded Consensus-Based Statement)
307795
In adult patients with unexplained chronic cough, we suggest a therapeutic trial of multimodality speech pathology therapy. (2, C)
307795
In adult patients with unexplained chronic cough and negative tests for bronchial hyperresponsiveness and eosinophilia (sputum eosinophils, exhaled nitric oxide), we suggest that inhaled corticosteroids not be prescribed. (2, B)
307795
In adult patients with unexplained chronic cough, we suggest a therapeutic trial of gabapentin as long as the potential side effects and the risk-benefit profile are discussed with patients before use of the medication and there is a reassessment of the risk-benefit profile at 6 months before continuing the drug. (2, C)
307795
In adult patients with unexplained chronic cough and a negative workup for acid gastroesophageal reflux disease, we suggest that proton pump inhibitor therapy not be prescribed. (2, C)
307795
Recommendation Grading
Overview
Title
Treatment Of Unexplained Chronic Cough
Authoring Organization
American College of Chest Physicians
Publication Month/Year
January 1, 2016
Last Updated Month/Year
August 1, 2023
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
Unexplained chronic cough (UCC) causes significant impairments in quality of life. Effective assessment and treatment approaches are needed for UCC.
Target Patient Population
Patients with unexplained chronic cough
Inclusion Criteria
Female, Male, Adolescent, Adult, Older adult
Health Care Settings
Ambulatory, Long term care, Outpatient
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Diagnosis, Management, Treatment
Diseases/Conditions (MeSH)
D003371 - Cough, D000071896 - Medically Unexplained Symptoms
Keywords
cough, chronic cough