Chronic Cough in Adult Patients
DOI: 10.3238/zfa.2014.0215-0221german translation / full article
Background: Cough is one of the most common reasons for encounter in a family practice. The Guideline „Cough“ of the German College of General Practitioners and Family Physicians (DEGAM) was updated in 2013 and contains current recommendations for primary care. Essential issues regarding chronic cough ( 8 weeks) are summarized in this article.
Methods: Based on a systematic literature search, current evidence was assessed. Recommendations for diagnosis and therapy were approved in a consensus conference with participation of seven scientific medical societies, according to the methodological standards for S3-guidelines.
Results: A focused medical history and clinical examination often allows a probable diagnosis. Signs of a serious illness like congestive heart failure, pulmonary embolism, bronchial carcinoma or aspiration of a foreign body should prompt urgent evaluation and initiation of treatment. In chronic cough, asthma, chronic obstructive bronchitis and side effects of medication should be considered on the first place and after that an Upper Airway Cough Syndrome, cough-variant asthma and gastroesophageal reflux. When diagnosed clinically, these conditions can first be treated empirically without further technical evaluation.
Conclusions: When no signs of a serious illness are found, common causes of chronic cough can be diagnosed and treated without further technical investigation in a primary care setting.