Emerging Trends in Paediatric Cough Management
| Dr. Yogesh Shakya
Cough is a common respiratory issue in children, typically resolving within 1–3 weeks. Causes include asthma, allergies, pertussis, foreign body aspiration, etc. A typical cough consists of four respiratory phases (inspiratory, compression, expiratory, and relaxation).1 Assessment of cough includes methods like visual analogue scales, cough symptom scores, and quality-of-life questionnaires, whereas chronic cough may require chest X-ray and pulmonary function tests. The clinical cues for describing cough comprise frequency, wet or dry nature, timing, and accompanying features. Referral criteria for severe cases include red flag features, such as systemic illness, respiratory distress, hemoptysis, and altered consciousness.2 Diagnostic workup for chronic productive purulent cough involves HRCT scan, bronchoscopy, and swallowing evaluation. Therapeutic strategies primarily address the underlying cause of cough, but symptomatic approaches are often necessary. Effective medications for cough include mucolytics such as Ambroxol, expectorants like Guaifenesin and Potassium iodide, Levodropropizine, local anaesthetics, Caramiphen, Carbetapentane or Pentoxyverine, and Levocloperastine. Recent studies indicate that Gefapixant, a selective antagonist of P2X3 and P2X2/3 receptors, has shown promise in treating chronic cough.3
"1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502102/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7123091/ 3. https://err.ersjournals.com/content/32/168/220219"