Management of Chronic Cough

Introduction to Chronic Cough Management

The American Thoracic Society recommends that codeine is not used for chronic cough due to limited evidence of efficacy and significant side effect concerns 1, 2

Codeine and other central cough suppressants have only shown intermediate benefit for short-term symptomatic relief of coughing in chronic bronchitis, but not for general chronic cough, with a Grade of recommendation B 2, 3
Peripheral cough suppressants such as levodropropizine and moguisteine are recommended for short-term symptomatic relief of coughing in chronic bronchitis with substantial benefit, and a Grade of recommendation A 2, 3
Ipratropium bromide is the only inhaled anticholinergic agent recommended for cough suppression in patients with cough due to chronic bronchitis, with a Grade of recommendation A 2, 3

For patients with severe airflow obstruction or frequent exacerbations of chronic bronchitis, inhaled corticosteroid therapy should be considered as it has been shown to reduce exacerbation rates and cough, according to Praxis Medical Insights 4