Guidelines to aid the medical practitioners in the evaluation and management of children with chronic cough. These guidelines include children less than/equal to 14 years of age with chronic cough (> 4 weeks duration). The guidelines are listed as follows-

11. For children aged ≤ 14 years with chronic cough, we suggest that if an empirical trial is used based on features consistent with a hypothesized diagnosis, the trial should be of a defined limited duration in order to confirm or refute the hypothesized diagnosis (Ungraded Consensus-Based Statement).
12. For children aged ≤ 14 years with chronic cough, we suggest that clinical studies aimed at evaluating cough etiologies use validated cough outcomes, use a-priori defined response and diagnosis, and take into account the period effect, and undertake a period of follow-up (Ungraded Consensus-Based Statement).
13. For children aged ≤ 14 years with chronic cough, we suggest that exacerbating factors such as environmental tobacco smoke exposure should be determined and intervention options for cessation advised or initiated (Ungraded Consensus-Based Statement).
14. For children aged ≤ 14 years with chronic cough, we suggest that parental (and when appropriate the child’s) expectations be determined, and their specific concerns sought and addressed (Ungraded ConsensusBased Statement).
15. For children aged ≤14 years with chronic (> 4 weeks duration) wet or productive cough unrelated to underlying disease and without any other specific cough pointers (eg, coughing with feeding, digital clubbing), we recommend 2 weeks of antibiotics targeted to common respiratory bacteria (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis) targeted to local antibiotic sensitivities (Grade 1A).
16. For children aged ≤ 14 years with chronic (> 4 weeks duration) wet or productive cough unrelated to underlying disease and without any other specific cough pointers (eg, coughing with feeding, digital clubbing) and whose cough resolves within 2 weeks of treatment with antibiotics targeted to local antibiotic sensitivities, we recommend that the diagnosis of PBB be made (Grade 1C).
17. For children aged ≤ 14 years with chronic (> 4 weeks duration) wet or productive cough unrelated to underlying disease and without any other specific cough pointers (eg, coughing with feeding, digital clubbing), when the wet cough persists after 2 weeks of appropriate antibiotics, we recommend treatment with an additional 2 weeks of the appropriate antibiotic(s) (Grade 1C).
18. For children aged ≤14 years with chronic (> 4 weeks duration) wet or productive cough unrelated to underlying disease and without any other specific cough pointers (eg, coughing with feeding, digital clubbing), when the wet cough persists after 4 weeks of appropriate antibiotics, we suggest that further investigations (eg, flexible bronchoscopy with quantitative cultures and sensitivities with or without chest CT) be undertaken (Grade 2B).
19. For children aged ≤ 14 years with PBB with lower airway (BAL or sputum) confirmation of clinically important density of respiratory bacteria (‡ 104 cfu/ mL), we recommend that the term ‘microbiologically based-PBB’ (or PBB-micro) be used to differentiate it from clinically-based-PBB (PBB without lower airway bacteria confirmation) (Grade 1C).
20. For children aged ≤ 14 years with chronic wet or productive cough unrelated to underlying disease and with specific cough pointers (eg, coughing with feeding, digital clubbing), we recommend that further investigations (eg, flexible bronchoscopy and/or chest CT, assessment for aspiration and/or evaluation of immunologic competency) be undertaken to assess for an underlying disease (Grade 1B).

Source: Chang, AB, Oppenheimer, JJ, Irwin, RS. Managing Chronic Cough as a Symptom in Children and Management Algorithms CHEST Guideline and Expert Panel Report, CHEST 2020; 158(1):303-329.