Cough guidelines introduce two terms

February 10, 2006

New evidence-based guidelines issued by the American College of Chest Physicians (ACCP) introduced two new terms, along with a comprehensive list of recommendations for the diagnosis and management of cough in adults and children.

New evidence-based guidelines issued by the American College of Chest Physicians (ACCP) introduced two new terms, along with a comprehensive list of recommendations for the diagnosis and management of cough in adults and children.1

The new terminology includes upper airway cough syndrome (UACS), which should now be used in preference to postnasal drip syndrome when considering cough that is associated with upper airway conditions, because it is unclear whether the mechanism of the cough is postnasal drip, direct irritation, or inflammation of cough receptors in the upper airway. The ACCP also recommends using the term unexplained cough rather than idiopathic cough because it is likely more than one unknown cause of chronic cough will emerge.

Richard S. Irwin, MD, of the University of Massachusetts Medical School in Worcester, and chair of the guidelines committee, notes that "the new ACCP guidelines define how physicians should diagnose and manage cough associated with everything from the common cold to chronic lung conditions. The guidelines also are the most comprehensive evidence-based recommendations for treating cough in children."

The guidelines include more than 200 recommendations for diagnosing and managing acute cough (a cough lasting less than three weeks), subacute cough (a cough lasting less than three to eight weeks), and chronic cough (a cough lasting more than eight weeks) in adults and children.

New to this revision of the "Managing cough as a defense mechanism and as a symptom," issued by the ACCP in 1998, are nonasthmatic eosinophilic bronchitis; acute bronchitis; environmental and occupational causes of cough; tuberculosis and other infections; and uncommon causes of cough, among others.

1. Irwin RS, Baumann MH, Boulet, L-P, et al: Executive summary: ACCP evidence-based guidelines. Chest 2006;129:1