BTS publishes cough management guidance
Steve Percival/Science Photo Library
Honey and lemon: recommended as simplest and cheapest treatment
option |
The first UK guidelines to provide evidence-based recommendations for the management of cough in adults are published
this week as a supplement
to Thorax (2006;61).
The British Thoracic Society guidelines define acute and chronic cough
and review available literature in terms of clinical evaluation and management
of cough.
The guidelines recommend that acute cough should be further investigated
if there is evidence of haemoptysis, prominent systemic illness, suspicion
of an inhaled foreign body or suspicion of lung cancer. Viral cough is
almost invariably benign and prescribed treatment is regarded as unnecessary,
they advise. Although patients report benefit from over-the-counter preparations
there is little evidence of a specific pharmacological effect, the guidelines
say. The simplest and cheapest treatment option may be a “home
remedy” such as honey and lemon, they suggest.
If OTC preparations are recommended, the guidelines highlight that dextromethorphan,
menthol and sedative antihistamines have demonstrated suppression of
the cough reflex. Codeine and pholcodine are also antitussives but are
not recommended since they have no greater efficacy than dextromethorphan
and are associated with a less favourable adverse events profile.
There are no effective treatments (with an acceptable side effect profile)
to control the cough response, the guidelines say. Several novel approaches,
which the guidelines discuss, are currently being developed. Finally,
the guidelines call for multicentre phase II trials of new drugs to be
carried out at specialist cough centres, using objective measures such
as cough counting. |
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