Prolonged cough doesn’t always need medications. A physician explained why.
A postinfectious cough persists for weeks after the original infection has cleared up, and it is being experienced by many people in Canada due to the current wave of respiratory diseases.
Respiratory infections are not uncommon, especially during the flu season. But what happens when the cough lingers long after the infection is gone? According to a physician, antibiotics may not be necessary in cases of prolonged cough.
Dr. Kevin Liang, a family physician and clinical instructor in the Department of Family Practice at the University of British Columbia, Vancouver, BC, emphasized that most cases of prolonged cough will improve without medication. Reassuring patients that postinfectious cough is time-limited and self-resolving is important and can reduce unnecessary and costly prescriptions, such as asthma puffers or antibiotics, Dr. Liang stated.
Here are five key points to understand about prolonged cough:
1. Length of Persistence: A postinfectious cough can linger for up to eight weeks even after the original respiratory infection has cleared.
2. Accurate Diagnosis: To identify postinfectious cough, it is essential to rule out other conditions that can mimic its symptoms, such as asthma and chronic obstructive pulmonary disease (COPD). A prior respiratory infection and exclusion of these mimics are necessary for a proper diagnosis.
3. Warning Signs: Certain symptoms should prompt further investigation. Severe dyspnea (difficulty breathing), trouble swallowing, blood in the cough, a history of recurrent pneumonia, or prolonged smoking can be warning signs. Coughs that persist beyond eight weeks require additional evaluation.
4. Lack of Efficacy: There is inadequate evidence to support the use of any specific medicine for postinfectious cough. Inhalers or oral drugs prescribed for cough relief have limited supportive data and can lead to adverse side effects and high costs.
5. Importance of Education and Follow-up: Patient education and comfort play a crucial role. Physicians should advise patients that postinfectious cough will likely resolve on its own. However, if the cough persists beyond eight weeks or new symptoms appear, a follow-up appointment for further testing should be scheduled.
Postinfectious cough, also known as post-viral cough, is a common after-effect of upper respiratory infections, such as the common cold. These coughs can continue for an extended period of three to eight weeks.
In adults, post-viral coughs typically have two primary causes. The first cause is postnasal drip, where mucus from the nose runs down the throat, resulting in irritation to the vocal cords and throat. This irritation worsens during the night when lying flat. When you’re lying flat at night, mucus runs down the back of your throat and into your lungs, explained Dr. Russell Buhr, a pulmonary and critical care physician at UCLA Health. It can cause chest congestion that needs to be coughed up. When mucus travels down your throat, it can also cause irritation and inflammation, making you cough.
The second cause of prolonged cough is inflammation resulting from the original respiratory illness or enlarged airways. In certain cases, a persistent cough could also indicate a secondary infection in the presence of pre-existing asthma. However, these instances require thorough evaluation by a medical professional.
While a prolonged cough can be concerning and disruptive, it is crucial to understand that in most cases, it does not require antibiotics or other medications. With the right education and reassurance from physicians, patients can find comfort knowing that the postinfectious cough will likely resolve on its own. By avoiding unnecessary prescriptions and costly treatments, individuals can focus on self-care measures and consult a healthcare professional if the symptoms persist or worsen.
