Cough in children: definitions and clinical evaluation
Anne B Chang1, Lou I Landau, Peter P Van Asperen
1Department of Respiratory Medicine, Royal Children's Hospital, Brisbane, Queensland. annechang@ausdoctors.net
Insights
Pediatric cough management differs from adults, requiring environmental assessments and consideration of serious issues like aspiration. Most childhood coughs are viral, and medications offer little relief for acute coughs.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Clinical Pharmacology
Background:
- Pediatric cough etiology and management diverge significantly from adult approaches.
- Empirical adult treatment strategies are inappropriate for children.
- Clinical assessment must include environmental factors like tobacco smoke and parental concerns.
Purpose of the Study:
- To highlight the distinct approach needed for pediatric cough management.
- To differentiate causes of acute versus chronic cough in children.
- To evaluate the efficacy of common treatments for pediatric cough.
Main Methods:
- Review of clinical evaluation parameters for pediatric cough.
- Analysis of common causes of acute and chronic cough in children.
- Assessment of medication effectiveness for symptomatic relief.
Main Results:
- Acute cough in children is often due to uncomplicated viral infections, but aspiration must be ruled out.
- Isolated chronic cough in children is seldom asthma; "cough variant asthma" is an inaccurate term.
- Over-the-counter and prescription medications are ineffective for acute cough symptom relief.
Conclusions:
- Pediatric cough requires a tailored clinical evaluation, considering environmental factors and potential serious conditions.
- Treatment for chronic cough should be etiology-based, not presumptive.
- Medication response in children's cough trials should be interpreted cautiously due to the condition's natural history.
Abstract:
The aetiology and management approach for cough in children differs greatly to that in adults, so the empirical approach commonly used in adults is unsuitable for children. Clinical evaluation of cough in children should include an assessment of environmental factors, particularly tobacco smoke, parental concerns and expectations. Most children with acute cough are likely to have an uncomplicated viral acute respiratory tract infection, but the possibility of a more serious problem, especially aspiration of foreign material, should always be considered. Isolated chronic cough in children is rarely asthma, and the term "cough variant asthma" should not be used. Over-the-counter and prescription medications are ineffective for the symptomatic relief of acute cough. Treatment for chronic cough should be based on aetiology. Because of the favourable natural history of cough, a "positive" response in medication trials should not be assumed to be due to the medication. Children should be reassessed within the expected timeframe of response to therapy.
Related Concept Videos
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:19Chronic Obstructive Pulmonary Disease IV: Clinical Manifestations
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
01:13Asthma III: Clinical Manifestations
01:17Pulmonary Cycle: Exhalation