Treatment of Acute Cough in Children

Primary Treatment Approach

• The American College of Chest Physicians recommends honey as the first-line treatment for acute cough in children, as it provides more relief for cough symptoms than no treatment, diphenhydramine, or placebo 1, 2

What NOT to Use

• The American Academy of Pediatrics suggests that over-the-counter cough and cold medicines should not be prescribed for children with acute cough, as they have not been shown to make cough less severe or resolve sooner 1, 2
• Codeine-containing medications must be avoided in children due to the potential for serious side effects, including respiratory distress 1, 2

Supportive Care Measures

• Ensuring adequate hydration is crucial to help thin secretions in children with acute cough 3
• Using antipyretics and analgesics can help keep the child comfortable, according to the American Academy of Pediatrics 3
• Gentle nasal suctioning may help if nasal congestion is present in children with acute cough 3
• Addressing environmental tobacco smoke exposure is essential if present, as recommended by the American College of Chest Physicians 1, 2

When to Reassess

• If cough persists beyond 2-4 weeks, the child should be re-evaluated for emergence of specific etiological pointers that might indicate a more serious underlying condition, according to the American College of Chest Physicians 1, 4
• At 4 weeks duration, the cough transitions from acute to chronic and requires systematic evaluation with chest radiograph and spirometry (when age-appropriate), as recommended by the American Thoracic Society 4, 2, 3

Parent Education

• Parents should be educated that warning signs requiring immediate medical attention include respiratory distress, difficulty breathing, oxygen saturation <92%, poor feeding, or signs of dehydration, according to the American Academy of Pediatrics 3