CHEST Guidelines-Chronic Cough Due to Stable Chronic Bronchitis

Chronic Cough Due to Stable Chronic Bronchitis

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The CHEST Expert Panel Report addresses chronic cough as a significant issue associated with stable chronic bronchitis (CB), impacting patients' quality of life. A systematic review was conducted to update the American College of Chest Physicians' 2006 guidelines on managing this condition. The investigation focused on three key questions about chronic cough due to CB: the clinical features that signify a cough-phlegm syndrome, if treatment can improve or eliminate cough, and whether it can prevent acute CB exacerbations.<br /><br />The study highlights that smoking and exposure to environmental pollutants are major risk factors for developing chronic cough linked to CB. It strongly advises against the routine use of pharmacologic treatments, such as antibiotics, bronchodilators, and mucolytics, for cough relief in CB cases due to insufficient evidence of their effectiveness. Moreover, non-pharmacologic treatments like positive expiratory pressure are also not recommended until proven safe and effective.<br /><br />Chronic bronchitis, which involves a persistent cough with sputum for at least three months annually over two consecutive years, is mainly exacerbated by smoking and exposure to inhaled irritants. The panel recognizes a considerable need for further research, given the limited and low-quality evidence available. Future efforts should include rigorous randomized controlled trials and explore multi-ingredient therapies to improve treatment options for CB-related chronic cough. The report ultimately aims to guide current treatment practices and identify research gaps for future exploration.

Keywords

chronic cough

chronic bronchitis

quality of life

systematic review

environmental pollutants

pharmacologic treatments

non-pharmacologic treatments

smoking

randomized controlled trials

treatment guidelines