Cough is separated into two categories such as acute cough that lasts for less than 3 weeks, and chronic cough lasts for more than 8 weeks. Acute cough is generally triggered by a viral infection due to the upper respiratory tract infection. In clinical practice, evidence of treatment efficacy is low and treatment of acute cough is very complex.

Chronic cough is the most common reason for consultation. The most common and frequent causes are upper airway infections, asthma, gastroesophageal reflux disease, eosinophilic bronchitis, and drugs. Before starting the investigation for chronic cough, smoking cessation and drug withdrawal must be attained for almost 4 to 6 weeks. After this step, simple investigations can be performed to discover the common causes of chronic cough (i.e., interrogative, spirometry, physical examination, chest X-ray).

If no causes are identified or cough remains in spite of the optimal treatment, then comprehensive investigation should be performed to exclude any rare causes. A chronic cough hypersensitivity syndrome is proposed if any causes found in spite of comprehensive evaluation or if cough remains with optimal management and treatments. This syndrome is generally characterized by a rise in the sensitivity of cough peripheral receptors and is also not sensitive to traditional therapies. The therapeutic options are inadequate but innovative treatments like P2X3 receptor antagonists are in developing.

Source: Guilleminault L, Brouquières D, Didier A. [From acute cough to chronic cough in adults: Overview on a common reason for consultation]. Presse Med. 2019 Apr;48(4):353-364. French. doi: 10.1016/j.lpm.2019.02.009. Epub 2019 Mar 27. PMID: 30926203.