Consensus statement on the evaluation and therapy of chronic cough in children

Currently no consensus guidelines on the evaluation and therapy of chronic cough in children have been published in German. Aim of this study was therefore, after a literature search on all relevant publications and guidelines concerning chronic cough in children, to publish a Statement of the Austrian Society of Pediatrics and The Austrian Society of Pneumology on the evaluation and therapy of chronic childhood cough and to publish a practice based approach. Aim was also to differentiate cough clearly from obstructive airway diseases and to summarize all relevant differential diagnosis using relevant patient history and clinical characteristics and give an overview of therapeutical approaches. The subjective component of cough and the difficulty to assess cough in an objective manner is discussed. A Cochrane and Medline Search were performed on all relevant literature until Mai 2013. Chronic cough in children is defined as daily cough for more than 4 weeks. Duration of 3 to 8 weeks is sometimes called prolonged or sub-acute cough. Chronic cough may have specific cause and may be a symptom of an underling disease, which needs to be found and treated adequately. Unspecific cough may only be diagnosed after exclusion of all other causes. Any therapeutical approach needs to be re- evaluated and efficacy needs to be reviewed. Parental understanding of the etiology of cough in general and the influence of environmental exposures is essential for diagnosis. Chronic cough needs a detailed history and various differential diagnoses need to be taken in consideration. Children with persistent complaints without a proper diagnosis need to be seen in a center specialized in Pediatric Respiratory Medicine.