[Acute Cough in Adult Patients]

Area of Science:

• Family Medicine
• General Practice
• Evidence-Based Medicine

Context:

• Acute cough is a common primary care complaint, often linked to respiratory infections.
• The German Guideline 'Acute and chronic cough' (DEGAM) was updated in 2021.
• The update provides evidence-based recommendations for managing acute cough in primary care settings.

Purpose:

• To present the updated 2021 Guideline for Acute Cough from the German College of General Practitioners and Family Physicians (DEGAM).
• To outline evidence-based diagnostic and management strategies for acute cough in primary care.
• To reduce the inappropriate use of antibiotics for acute cough and uncomplicated bronchitis.

Summary:

• Diagnostic evaluation relies on history, red flag screening, and physical examination.
• For likely acute, uncomplicated bronchitis, avoid laboratory tests, sputum diagnostics, chest X-rays, and antibiotics.
• Evidence for antitussive, expectorant, and phytotherapeutic agents is limited; COVID-19 should be considered.
• Delayed prescribing and shared decision-making are strategies to avoid antibiotic therapy.
• Further diagnoses are indicated if specific symptoms or red flags appear, considering conditions like pneumonia or COPD exacerbations.

Impact:

• Aims to decrease antibiotic prescriptions for viral respiratory infections and acute bronchitis.
• Highlights the limited evidence for symptomatic cough treatments, guiding clinical practice.
• Calls for further clinical trials to strengthen the evidence base for symptomatic cough therapies.