Prolonged cough in adults
EBM Guidelines
Dec 27, 2022 • Latest change Oct 23, 2023
Table of contents
- Essentials
- Causes
- Examination
- Upper airway cough syndrome (mucus draining down the back of the throat)
- Asthma
- Gastro-oesophageal reflux disease
- Cough associated with medication
- Cough beginning with symptoms of respiratory tract infection
- Chronic bronchitis and COPD
- Eosinophilic bronchitis
- Other respiratory diseases
- Other causes
- Symptomatic treatment
- References
Extract
- A cough that lasts more than 3 weeks is regarded as prolonged cough, and a cough that lasts more than 8 weeks as chronic cough.
- Most important causes: mucus in the nasopharynx for various reasons, asthma and gastro-oesophageal reflux disease. Cough may be the only symptom in all of these.
- Cough may be prolonged after a respiratory tract infection due to bronchial hyperreactivity but it may also be a symptom caused by maxillary sinusitis or new-onset asthma.
- In smokers, the most common cause of cough is COPD or chronic bronchitis.
- ACE inhibitors are the most common drugs associated with cough, but beta blockers in asthmatic patients, nitrofurantoin and methotrexate should also be considered.
- The cause should be treated, ex juvantibus as necessary (asthma, gastro-oesophageal reflux disease). If causal treatment is not possible and the cough interferes significantly with the patient's life, antitussives can be used for symptomatic treatment.
Linked evidence summaries
Search terms
Adult, Cardiology, Cough, Hemoptysis, Internal medicine, Pulmonary diseases, R05, Radiography, Thoracic, Tranexamic Acid, prolonged cough