CICADA: Cough in children and Adults: Diagnosis and Assessment. Australian Cough Guidelines summary statement

Peter Gibson, Anne Chang, Nicholas Glasgow, Peter Holmes, Andrew Kemp, Peter Katelaris, Louis Landau, Stuart Mazzone, Peter Newcombe, Peter Van Asperen, Anne Vertigan

    Research output: Contribution to journalComment/debate

    Abstract

    • Cough is a common and distressing symptom that results in significant health care costs from medical consultations and medication use. 

    • Cough is a reflex activity with elements of voluntary control that forms part of the somatosensory system involving visceral sensation, a reflex motor response and associated behavioural responses. 

    • At the initial assessment for chronic cough, the clinician should elicit any alarm symptoms that might indicate a serious underlying disease and identify whether there is a specific disease present that is associated with chronic cough. 

    • If the examination, chest x-ray and spirometry are normal, the most common diagnoses in ADULTS are asthma, rhinitis or gastro-oesophageal reflux disease (GORD). The most common diagnoses in CHILDREN are asthma and protracted bronchitis. 

    • Management of chronic cough involves addressing the common issues of environmental exposures and patient or parental concerns, then instituting specific therapy. 

    • In ADULTS, conditions that are associated with removable causes or respond well to specific treatment include protracted bacterial bronchitis, angiotensin-converting enzyme inhibitor use, asthma, GORD, obstructive sleep apnoea and eosinophilic bronchitis. 

    • In CHILDREN, diagnoses that are associated with removable causes or respond well to treatment are exposure to environmental tobacco smoke, protracted bronchitis, asthma, motor tic, habit and psychogenic cough. 

    • In ADULTS, refractory cough that persists after therapy is managed by empirical inhaled corticosteroid therapy and speech pathology techniques.
    Original languageEnglish
    Pages (from-to)265-271
    Number of pages7
    JournalMedical Journal of Australia
    Volume192
    Issue number5
    DOIs
    Publication statusPublished - 2010

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