The Pharmaceutical Journal
Vol 268 No 7199 p705-712
25 May 2002

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Delay child cough re-referrals, say GPs

Parents of children with acute cough should be advised that symptoms can take longer than expected to clear.

Dr Alastair Hay, division of primary health care, University of Bristol, and Dr Andrew Wilson, department of general practice and primary health care, University of Leicester, reviewed 10 trials that described the natural history of acute cough in children. They found, as expected, that the proportion of children improving or recovering increased over time. However, they say that two weeks after being seen by their general practitioners, up to 24 per cent of children will not have improved or will be worse, and 66 per cent may still be experiencing symptoms. They add that nasal discharge and cough are still present in half of children at one week and between 10 and 20 per cent at three weeks. Complications of acute cough can be expected in 12 per cent of children, the most common being otitis media. The researchers say that precise information about the duration of illness and specific symptoms will reassure parents of the benign nature of the illness.

"Given that many children still experience nasal discharge and cough one week after consultation, it may be necessary to advise parents to delay reconsultation for these symptoms in an otherwise well child for two to three weeks," the researchers conclude (British Journal of General Practice 2002;52:401).