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Cough in children
Adelaida Lamas1, Marta Ruiz de Valbuena1, Luis Máiz2
1Sección de Neumología Pediátrica, Hospital Universitario Ramón y Cajal, Madrid, España; Unidad de Fibrosis Quística, Hospital Universitario Ramón y Cajal, Madrid, España; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, España.
Insights
Pediatric cough is common, often viral. Persistent cough requires evaluation for specific causes. Over-the-counter remedies are not recommended due to potential side effects.
Area of Science:
- Pediatrics
- Pulmonology
Background:
- Cough is a frequent pediatric complaint, necessitating distinct diagnostic and treatment approaches compared to adults.
- While viral infections commonly cause acute cough, persistent or chronic cough in children warrants thorough investigation.
Purpose of the Study:
- To outline the diagnostic and therapeutic strategies for pediatric cough.
- To emphasize the importance of etiological diagnosis and appropriate management.
Main Methods:
- Review of current pediatric guidelines for cough diagnosis and management.
- Emphasis on clinical evaluation to identify underlying causes of persistent cough.
Main Results:
- An optimal diagnostic approach can identify the cause in approximately 80% of pediatric cough cases.
- Effective treatment is achievable in about 90% of diagnosed cases.
- Empirical treatment may be considered for nonspecific chronic cough.
Conclusions:
- Cough management in children must be etiology-based.
- Over-the-counter cough medications are not recommended due to lack of evidence and potential risks.
- Adherence to pediatric-specific guidelines ensures effective diagnosis and treatment.
Abstract:
Cough during childhood is very common, and is one of the most frequent reasons for consultation in daily pediatric practice. The causes differ from those in adults, and specific pediatric guidelines should be followed for correct diagnosis and treatment. The most common cause of cough in children is viral infection producing "normal cough", but all children with persistent cough, i.e. a cough lasting more than 4-8weeks or "chronic cough", must be carefully evaluated in other to rule out specific causes that may include the entire pediatric pulmonology spectrum. The treatment of cough should be based on the etiology. Around 80% of cases can be diagnosed using an optimal approach, and treatment will be effective in 90% of them. In some cases of "nonspecific chronic cough", in which no underlying condition can be found, empirical treatment based on the cough characteristics may be useful. There is no scientific evidence to justify the use of over-the-counter cough remedies (anti-tussives, mucolytics and/or antihistamines), as they could have potentially serious side effects, and thus should not be prescribed in children.
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