Chronic non-specific cough in children

Non-specific chronic cough refers to cough of more than 4 weeks duration with no symptoms or signs suggestive of a likely underlying problem. Management of children with chronic cough includes: an evaluation for these symptoms and signs; a chest radiograph and spirometry (where age-appropriate); as well as an assessment of environmental factors (in particular tobacco smoke), parental concerns and expectations. As the aetiology and management of cough in children differs greatly to that in adults, the empirical approach commonly used in adults is unsuitable for children. Treatment for chronic cough in children should be based on aetiology. Over-the-counter and prescription medications are ineffective and should be rarely used for the symptomatic relief of cough. Because of the favourable natural history of non-specific cough, if medication trials are undertaken, a ‘positive’ response should not be assumed to be due to the medication tried. Children should be re- assessed within the expected timeframe of response to therapy. This article reviews the management of children with cough, focusing on non-specific cough.