Abstract
BackgroundAcute cough is one of the most common complaints prompting patient visits to healthcare professionals. Despite the broad repercussions of acute cough on patient quality of life, school and work productivity, and public health resources, research on this condition is minimal, as are the available treatment options. Many patients use over-the-counter medicines, which are often ineffective for symptom relief. Some therapies may achieve antitussive activity, but at the expense of unpleasant or intolerable side effects.Unmet needsWhen considering the treatments currently available for the management of acute cough, the multiple limitations of such treatments are quite apparent. Most of these treatments lack clinically proven efficacy and reliability to support their use. This reinforces the need for the generation of quality scientific data from well-performed clinical trials. Hopefully, the result will be the development of safer, more effective and more reliable therapeutic options in the management of acute cough.Cough assessment and managementAcute cough can be due to a variety of causes, and it is worthwhile to consider these pathogenic factors in some detail. It is also important to be familiar with the effects that acute cough has on patients' quality of life, work productivity, and the healthcare system; proper awareness of these effects may contribute to better understanding of the social impact of cough. In reference to the available treatments for the management of acute cough, adequate knowledge of the type of over-the-counter and prescription products in the market, as well as their mode of action and advantages/disadvantages, may provide expanded pharmacotherapeutic opportunities and facilitate better clinical decisions. However, due to the drawbacks of current treatment options, ideas for future cough management and newer products need to be considered and tested.ConclusionIn view of the socio-economic impact of acute cough and the limitations of available treatments, a renewed interest in the management of acute cough needs to be encouraged. The current strategies for acute cough management need to be reassessed, with a focus on developing new, reliable products and formulations with proven efficacy and safety.
Highlights
Introduction to acute coughAcute cough is one of the most common symptoms for which patients seek medical attention and spend healthcare dollars [1], the most common new presentation in primary care [2], and the most frequent reason for visits to hospital-based outpatient clinics [3]
This article reviews the limited research in acute cough, the impact of acute cough on quality of life and health economics, current treatment options, and potential treatments to satisfy unmet needs in the management of this common ailment
Current OTC treatments Most patients initially use OTC cough and cold medicines to relieve acute cough and other symptoms associated with upper respiratory tract infection (URTI)
Summary
In view of the socio-economic impact of acute cough and the limitations of available treatments, a renewed interest in the management of acute cough needs to be encouraged. Current OTC treatments Most patients initially use OTC cough and cold medicines to relieve acute cough and other symptoms associated with URTIs. a Cochrane review of OTC cough medicines, based on randomized controlled trials in children and adults, failed to clearly demonstrate the effectiveness of these medicines. Current ACCP guidelines do not recommend the use of peripherally or centrally acting cough suppressants for the treatment of cough due to URTIs, and discourage the use of OTC combinations for the treatment of acute cough due to the common cold, except for an older combination of a first-generation antihistamine plus a decongestant [39]. These include large-conductance calcium-activated potassium channel openers and agents selectively targeting various receptors (e.g., vanilloid receptor antagonists, selective opioid or opioidlike receptor agonists, tachykinin receptor antagonists, endogenous cannabinoid type-1 receptor agonists and antagonists, 5-hydroxytryptamine receptor agonists) [47]
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