Prolonged cough? In most cases, patience is the treatment

Coughing after a respiratory infection is common and, in most cases, will resolve with time, according to an article in CMAJ (Canadian Medical Association Journal).

With the recent bout of respiratory infections across Canada, many people are suffering from a postinfectious cough, or a cough that lasts for weeks after the initial infection has resolved.

"Reassuring patients that postinfectious cough is time limited and self resolving is important and can reduce unnecessary and costly prescriptions, such as asthma puffers or antibiotics," said Dr. Kevin Liang, a family physician and clinical instructor in the Department of Family Practice at the University of British Columbia, Vancouver, BC. "Most postinfectious cough symptoms will improve without medication."

Key points about postinfectious cough:

1. Postinfectious coughs are common, affecting about 11% to 25% of adults after a respiratory infection and can last up to 8 weeks.

2. Diagnosis requires an earlier respiratory infection and exclusion of other post infectious cough mimics, such as asthma and chronic obstructive pulmonary disease.

3. Check for red flags and cough duration. Symptoms such as swallowing difficulty, excessive shortness of breath, and coughing up blood may require investigation. Red flags include a history of recurrent pneumonia or an extended history of smoking, and coughs lasting longer than 8 weeks need further assessment.

4. There is no good evidence for a medication that works to stop postinfectious cough. Evidence shows little benefit with inhalers or oral medications to treat a cough. These medications can be quite costly and cause unwanted side effects as well.

5. Patient reassurance and education are critical. Clinicians should advise patients to arrange a follow-up appointment for further investigation if their cough has not resolved within 8 weeks or if new symptoms appear.

Reference:

Kevin Liang, Philip Hui and Samantha Green, Postinfectious cough in adults, Canadian Medical Association Journal, DOI: https://doi.org/10.1503/cmaj.231523.