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When to Treat, When to Refer

 |  Dr. Arif Mohammed  |  489 Views

Coughing is a complex reflex involving muscles and neural pathways. While typically a healthy response, persistent or chronic coughing can signal underlying health issues.[1] Cough is categorised into acute, subacute, and chronic types based on symptom duration. Initial evaluation in children includes thorough history, physical examination, chest X-ray, and spirometry. Referral to specialists is necessary for persistent chronic cough with red-flag symptoms like choking or recurrent infections.[2] Management focuses on treating the underlying cause; for instance, antibiotics for protracted bacterial bronchitis and inhaled medications for asthma. Paediatric guidelines do not recommend over-the-counter medicines (including antitussives, expectorants, mucolytics, and antihistamines) for acute cough due to insufficient evidence of effectiveness.[3]

Reference(s):

1. https://www.ncbi.nlm.nih.gov/books/NBK430791/#:~:text=Cough%20can%20be%20divided%20into,weeks

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8804402/#:~:text=Often%2C%20a%20child's%20cough%20naturally,lasting%20more%20than%20four%20weeks

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9860236/#:~:text=Treatment%20of%20chronic%20cough,The%20management%20of&text=For%20non%2Dspecific%20chronic%20pediatric,17%2C%2020%2C%2040%5D