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The difficult-to-treat, therapy-resistant cough: Why are current cough treatments not working and what can we do?

2013; Elsevier BV; Volume: 26; Issue: 5 Linguagem: Inglês

10.1016/j.pupt.2013.05.001

1522-9629

Lorcan McGarvey,

Gastroesophageal reflux and treatments

Cough can persist despite exhaustive diagnostic and therapeutic effort and has been termed 'idiopathic' or 'unexplained' but perhaps 'difficult to treat' cough is a more appropriate description. In this article the reasons for poor treatment response are discussed. These include a lack of physician fidelity to management guidelines, patient non-adherence and the lack of effective medicines. A number of randomized controlled trials have been undertaken including low dose opiate therapy, the use of a speech pathology intervention, oral antibiotics and antidepressants. The success or otherwise of such interventions will be discussed. A number of approaches to deal with the problem of 'difficult to treat cough' will be considered.