Chronic cough due to chronic bronchitis: ACCP evidence-based clinical practice guidelines.
Chronic cough due to chronic bronchitis: ACCP evidence-based clinical practice guidelines.
1st January 2006
American College of Chest Physicians - Medical Specialty Society
Summary,
American College of Chest Physicians - Medical Specialty Society
Summary,
GUIDELINE OBJECTIVE(S)
To present the evidence for the diagnosis and treatment of cough due to chronic bronchitis, and to make recommendations that will be useful for clinical practice
TARGET POPULATION
Patients with cough due to chronic bronchitis
INTERVENTIONS AND PRACTICES CONSIDERED
Diagnosis
1. Medical history (including a complete history regarding exposures to respiratory irritants including cigarette, cigar, and pipe smoke; passive smoke exposures; and hazardous environments in the home and workplace)
2. Physical examination
Treatment
1. Avoidance of exposure to respiratory irritants
2. Antibiotics
3. Beta-agonist bronchodilators (short- and long-acting)
4. Ipratropium bromide
5. Theophylline
6. Anticholinergic bronchodilators
7. Inhaled corticosteroids
8. Systemic corticosteroids
9. Cough suppressants
* Codeine
* Dextromethorphan
Interventions considered but not recommended include postural drainage and chest percussion, expectorants, and the long-term maintenance therapy of oral corticosteroids such as prednisone.
MAJOR OUTCOMES CONSIDERED
* Reduction of symptoms (including cough and sputum production)
* Frequency of exacerbations of chronic obstructive pulmonary disease (COPD)
* Lung function (forced expiratory volume in 1 second, [FEV1])
