Chronic Cough in Children: A Primary Care and Subspecialty Collaborative Approach

Educational Gap

Cough is an extremely common symptom in children and a cause of great concern. Because cough can be caused by a wide variety of infectious and noninfectious conditions, which will vary among different age groups, clinicians must take a logical approach to establishing a diagnosis, which will determine appropriate therapy. General pediatricians must know how to work in coordination with specialists when the cause of the cough is unknown or complex.

Objectives

After reading this article, readers should be able to:

1. Effectively evaluate the multiple causes of cough in children of various ages.

2. Prescribe appropriate therapies for the disorders that cause cough.

3. Understand how to coordinate the care of the generalist with that of the specialist.

Cough – cough – cough – cough! A great many parents, grandparents, teachers, and child care providers express concern to health care clinicians regarding a child’s cough. Many hours of sleep and days of school and work are missed because of a child’s coughing. Simply suppressing the cough is not the answer because cough is an essential protective mechanism to keep the airways patent and clear. Well-meaning parents and grandparents often are quick to use over-the-counter products to suppress the cough, usually with no relief and occasionally with significant toxic effects.

Treatment of cough is not a “one size fits all” proposition. Rather, the clinician must evaluate each case of cough individually and determine treatment according to the cause of the cough. It is important to consider the age of the child, the nature and timing of the cough (wet or dry, day or …