[Acute and chronic cough-What is new?]

Area of Science:

• Respiratory Medicine
• Pharmacology

Context:

• Acute and subacute coughs (up to 8 weeks) are frequently viral and self-limiting.
• Chronic cough (over 8 weeks) may be chronic idiopathic cough (CIH) if no other respiratory cause is found.
• CIH is characterized by a hypersensitive cough reflex triggered by various stimuli.

Purpose:

• To differentiate causes of acute, subacute, and chronic cough.
• To highlight effective treatments for cough symptom relief.
• To define chronic idiopathic cough (CIH) and chronic refractory cough.

Summary:

• Viral infections are the primary cause of acute and subacute coughs.
• Herbal compounds, dextromethorphan, and ambroxol offer symptomatic relief.
• Antibiotics are ineffective for cough and contribute to resistance; their use is discouraged.
• Chronic idiopathic cough (CIH) is defined as cough >8 weeks without an identifiable respiratory cause, stemming from cough reflex hypersensitivity.
• Chronic refractory cough is diagnosed when guideline-conform treatment for CIH fails.

Impact:

• Informs appropriate diagnostic and treatment pathways for different cough durations.
• Discourages antibiotic use for cough, mitigating antimicrobial resistance.
• Establishes CIH as a distinct condition requiring specific management approaches.
• Guides clinicians in identifying and managing challenging cases of chronic refractory cough.