By vgreene, 23 September, 2020 For unexplained cough after comprehensive eval: Therapy for somatic cough disorder8,9 (aka, habit/tic/psychogenic) lacks evidence in children. Reassurance, psychotherapy, counseling, suggestion tx, hypnosis, etc, have been suggested2
By vgreene, 23 September, 2020 Don’t use OTC cough meds, d/t adverse event risk, insufficient evidence of benefit. Honey may help cough (avoid if
By vgreene, 23 September, 2020 Don’t empirically tx UACS/postnasal drip from sinus dz (controversial pedi cause), GERD (rare pedi cause5), or asthma unless clinical features beyond cough present.1,5 Set time limit on tx trials.1 Post-acute viral bronchiolitis cough: Don’t use asthma dr
By vgreene, 23 September, 2020 If tx trial chosen, f/u in 2-4wk. If sx resolving, consider asthma or asthma-like dz, f/u in 2-4 more wks; then stop steroids if no other asthma features.1 If sx persist on tx trial (after 4-8-wk steroid trial, per ERS2), stop inhaled steroids,2 re-eval f
By vgreene, 23 September, 2020 If cough persists @ 2-wk re-eval: Re-✓ for specific-cough s/sx.1 If none, then either watch/wait x2 more wks or consider inhaled steroid 2-4-wk tx trial1,2 (budesonide 400 ug/day or equivalent)1
