Viral infections and persistent cough: Evidence for treatment options

Upper respiratory tract infections (URTIs) are one of the most common presentations to Australian general practitioners. Patients often present hoping to be cured, but most URTIs are caused by viral infections, so the task of management is predominantly symptomatic. Patients may be impatient to recover from cough because of concerns from others regarding infectivity from potential SARS-CoV-2 infection. Unfortunately, the effectiveness of interventions is poorly understood and lacking a robust evidence base. As a result, URTIs are a common presentation leading to unnecessary use of antibiotics or ineffectual treatments.

The aim of this article is to improve the management of acute cough, a common reason for consulting a general practitioner. Understanding the pathophysiology and time course of this symptom informs selection of evidence-based treatment options and supports better antibiotic stewardship.

URTI presentations provide fertile ground for educating patients about infections, self-management options, dealing with uncertainty and responsible use of medicines.