Managing Chronic Cough as a Symptom in Children and Management Algorithms: CHEST Guideline and Expert Panel Report

Anne B. Chang, John J. Oppenheimer, Richard S. Irwin, Todd M. Adams, Kenneth W. Altman, Elie Azoulay, Fiona Blackhall, Surinder S. Birring, Donald C. Bolser, Louis Philippe Boulet, Sidney S. Braman, Christopher Brightling, Priscilla Callahan-Lyon, Terrie Cowley, Paul Davenport, Ali A. El Solh, Patricio Escalante, Stephen K. Field, Dina Fisher, Cynthia T. FrenchCameron Grant, Susan M. Harding, Anthony Harnden, Adam T. Hill, Peter J. Kahrilas, Joanne Kavanagh, Karina A. Keogh, Kefang Lai, Andrew P. Lane, Craig Lilly, Kaiser Lim, Mark Lown, J. Mark Madison, Mark A. Malesker, Stuart Mazzone, Lorcan McGarvey, Alex Molasoitis, M. Hassan Murad, Mangala Narasimhan, John Oppenheimer, Richard J. Russell, Jay H. Ryu, Sonal Singh, Maeve P. Smith, Susan M. Tarlo, Anne E. Vertigan

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: Cough is one of the most common presenting symptoms to general practitioners. The objective of this article is to collate the pediatric components of the CHEST chronic cough guidelines that have recently updated the 2006 guidelines to assist general and specialist medical practitioners in the evaluation and management of children who present with chronic cough. Methods: We reviewed all current CHEST Expert Cough Panel's statements and extracted recommendations and suggestions relating to children aged ≤ 14 years with chronic cough (> 4 weeks duration). Additionally, we undertook systematic reviews to update other sections we considered relevant and important. Results: The eight recent CHEST guidelines relevant to children, based on systematic reviews, reported some high-quality evidence in the management of chronic cough in children (eg, use of algorithms and management of wet/productive cough using appropriate antibiotics). However, much evidence is still inadequate, particularly in the management of non-specific cough in the community. Conclusions: The recommendations and suggestions related to the management of chronic cough in the pediatric age group have been based upon high-quality systematic reviews and are summarized in this article. Compared to the 2006 Cough Guidelines, there is now high-quality evidence for some aspects of the management of chronic cough in children. However, further studies particularly in primary health care are required.

Original languageEnglish (US)
Pages (from-to)303-329
Number of pages27
Issue number1
StatePublished - Jul 2020


  • children
  • cough
  • evidence-based medicine
  • guideline
  • treatment

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine


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