Maeve P Smith1, Mark Lown2, Sonal Singh3, Belinda Ireland4, Adam T Hill5, Jeffrey A Linder6, Richard S Irwin7. 1. Division of Pulmonary Medicine, University of Alberta, Edmonton, AB, Canada. Electronic address: maeve1@ualberta.ca. 2. Primary Care and Population Science, University of Southampton, Southampton, England. 3. UMass Medical School, Family Medicine & Community Health & Meyers Primary Care Institute, Worcester, MA. 4. TheEvidenceDoc, Pacific, MO. 5. Department of Respiratory Medicine, Royal Infirmary of Edinburgh and University of Edinburgh, Edinburgh, Scotland. 6. Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL. 7. UMass Memorial Medical Center, Worcester, MA.
Abstract
BACKGROUND: Evidence for the diagnosis and management of cough due to acute bronchitis in immunocompetent adult outpatients was reviewed as an update to the 2006 "Chronic Cough Due to Acute Bronchitis: American College of Chest Physicians (ACCP) Evidence-Based Clinical Practice Guidelines." METHODS: Acute bronchitis was defined as an acute lower respiratory tract infection manifested predominantly by cough with or without sputum production, lasting no more than 3 weeks with no clinical or any recent radiographic evidence to suggest an alternative explanation. Two clinical population, intervention, comparison, outcome questions were addressed by systematic review in July 2017: (1) the role of investigations beyond the clinical assessment of patients presenting with suspected acute bronchitis, and (2) the efficacy and safety of prescribing medication for cough in acute bronchitis. An updated search was undertaken in May 2018. RESULTS: No eligible studies relevant to the first question were identified. For the second question, only one relevant study met eligibility criteria. This study found no difference in number of days with cough between patients treated with an antibiotic or an oral nonsteroidal antiinflammatory agent compared with placebo. Clinical suggestions and research recommendations were made based on the consensus opinion of the CHEST Expert Cough Panel. CONCLUSIONS: The panelists suggested that no routine investigations be ordered and no routine medications be prescribed in immunocompetent adult outpatients first presenting with cough due to suspected acute bronchitis, until such investigations and treatments have been shown to be safe and effective at making cough less severe or resolve sooner. If the cough due to suspected acute bronchitis persists or worsens, a reassessment and consideration of targeted investigations should be considered.
BACKGROUND: Evidence for the diagnosis and management of cough due to acute bronchitis in immunocompetent adult outpatients was reviewed as an update to the 2006 "Chronic Cough Due to Acute Bronchitis: American College of Chest Physicians (ACCP) Evidence-Based Clinical Practice Guidelines." METHODS: Acute bronchitis was defined as an acute lower respiratory tract infection manifested predominantly by cough with or without sputum production, lasting no more than 3 weeks with no clinical or any recent radiographic evidence to suggest an alternative explanation. Two clinical population, intervention, comparison, outcome questions were addressed by systematic review in July 2017: (1) the role of investigations beyond the clinical assessment of patients presenting with suspected acute bronchitis, and (2) the efficacy and safety of prescribing medication for cough in acute bronchitis. An updated search was undertaken in May 2018. RESULTS: No eligible studies relevant to the first question were identified. For the second question, only one relevant study met eligibility criteria. This study found no difference in number of days with cough between patients treated with an antibiotic or an oral nonsteroidal antiinflammatory agent compared with placebo. Clinical suggestions and research recommendations were made based on the consensus opinion of the CHEST Expert Cough Panel. CONCLUSIONS: The panelists suggested that no routine investigations be ordered and no routine medications be prescribed in immunocompetent adult outpatients first presenting with cough due to suspected acute bronchitis, until such investigations and treatments have been shown to be safe and effective at making cough less severe or resolve sooner. If the cough due to suspected acute bronchitis persists or worsens, a reassessment and consideration of targeted investigations should be considered.
Authors: Xiaodong Guan; Luwen Shi; Mengyuan Fu; Haishaerjiang Wushouer; Lin Hu; Nan Li; Dennis Ross-Degnan Journal: NPJ Prim Care Respir Med Date: 2021-05-10 Impact factor: 2.871
Authors: Su Won Lee; Yee Ran Lyu; Si Yeon Kim; Won Kyung Yang; Seung Hyung Kim; Ki Mo Kim; Sung-Wook Chae; Weechang Kang; In Chul Jung; Yang Chun Park Journal: Front Pharmacol Date: 2022-01-17 Impact factor: 5.810