1st January 2006
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])