CHEST Guidelines-Managing-Chronic-Cough-as-a-Symptom-in-Children-an

Managing-Chronic-Cough-as-a-Symptom-in-Children-an

Pdf Summary

The CHEST Guideline and Expert Panel report provides updated recommendations for managing chronic cough in children, defined as a daily cough lasting more than four weeks in those under 14 years old. This guide assists practitioners in diagnosing and treating chronic cough while considering the unique causes and management options in children compared to adults.<br /><br />Key recommendations emphasize a systematic approach using pediatric-specific algorithms based on cough characteristics and clinical history. It advises against assuming that adult cough etiologies apply to children and stresses the need to consider the child’s age and clinical setting. Common in primary healthcare, chronic cough lacks management evidence distinct from adult scenarios, demanding further research.<br /><br />Diagnostic steps include chest radiographs and optional spirometry for children six years and older. Special investigations such as bronchoscopy or CT scans should be individualized based on specific clinical indicators.<br /><br />The panel encourages addressing modifiable environmental factors like tobacco smoke exposure, discussing parental expectations, and using educational interventions to reduce anxiety. For wet or productive coughs with no underlying disease, a short antibiotic course is recommended; if unresolved, further evaluation is needed to exclude conditions like protracted bacterial bronchitis.<br /><br />The guideline is cautious about the empirical treatment for gastroesophageal reflux disease (GERD) or upper airway cough syndrome, advising treatment only if GI symptoms are evident. It discourages the use of over-the-counter medications for symptomatic cough relief due to insufficient evidence of efficacy and potential risks, highlighting codes of conduct for TB management in high-prevalence regions.<br /><br />Overall, the guidelines integrate high-quality evidence and systematic reviews to support precise pediatric cough management. They emphasize environmental considerations and the importance of aligning treatment with the specific etiology rather than generic symptomatic relief. Further studies are essential to enhance evidence-based practices in this domain.

Keywords

chronic cough

children

pediatric guidelines

diagnosis

treatment

environmental factors

antibiotics

GERD

over-the-counter medications

evidence-based practices