Cough Treatment

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Cough

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Please read the following information before you start a diagnosis.

A cough occurs when you have a reflex action that forces air up and out of the lungs. An acute cough lasts less than 3 weeks, and if it lasts longer then it is advisable to see your GP for a physical assessment. An acute cough caused by an infection will usually improve after one week, however, it may take up to 3 weeks for the symptoms to settle completely.

The most common cause of an acute cough is a viral infection affecting the respiratory tract (breathing passages including the nose, mouth, throat, airways and lungs). Many respiratory tract infections will settle on their own without any specific treatment. Rest, drinking fluids and taking over-the-counter treatments as advised by your pharmacist will usually help the symptoms settle. Antibiotics are usually not required in the treatment of most coughs. Unnecessary use of antibiotics may cause side effects and may increase the incidence of antibiotic resistance. They are reserved for consideration in cases where the symptoms are not improving or if the infection has settled on the chest. 

Treatments we may prescribe if clinically appropriate:

Please see the Common Treatments section below for further information.


Common Symptoms

Symptoms of a Respiratory Tract Infection include:

  • a cough
  • mucous (phlegm)
  • a low-grade fever
  • a runny nose
  • sneezing
  • a blocked nose
  • a sore throat
  • general aches and pains

Most symptoms are at their worst after 2 to 3 days then will gradually settle. A cough may remain, however, for a couple of weeks, even after the infection has gone, but you would usually feel well in yourself at this stage.

Common Treatments

Most Respiratory Tract Infections are viral, do not require antibiotics, and will improve within a week on their own. Common treatments for the symptoms include paracetamol or ibuprofen, which help with any aches or pains and fever. You can seek further advice about cough and cold remedies from your pharmacist. Please note that symptoms of a viral cough may take up to three weeks to settle.

If however, you feel that your cough has settled on your chest or if your symptoms are worsening instead of improving, then you may wish to 'Start a Diagnosis' with i-GP or see your own GP.

Possible treatments we may prescribe if clinically appropriate:

  • Amoxicillin 500mg three times daily: 5-day course (£0.82*)
  • Doxycycline 100mg 2 immediately then one a day: 5-day course (£0.81*)
  • Clarithromycin 500mg twice daily: 5-day course (£1.97*)

*Prices shown are cost price of the medication, taken from the British National Formulary 2018, and are given as a guideline. Pharmacies will add a dispensing fee to this which will vary considerably, so it is worthwhile phoning around to compare prices. The medication is paid for at your chosen pharmacy. 

Please click on the medication above to read the Patient Information Leaflet for important information about each drug. We use national prescribing guidelines to select which treatment would be most appropriate for your condition. 

Respiratory Tract Infections

The two types of respiratory tract infections include: 

  • Upper Respiratory Tract Infection (URTI) which affects the nose, sinuses and throat.
  • Lower Respiratory Tract Infection (LRTI) which affects the breathing tubes (trachea and bronchi) and lungs.

Respiratory tract infections spread through coughing, sneezing or breathing droplets which are infected with the germs. If these are breathed in by someone else, then the infection may be passed on. The infection can also be spread through direct contact with another person or through indirect contact, such touching surfaces which are contaminated with the germs. 

To prevent spreading infections, it is important to practise good hygiene. This would include washing your hands with soap and warm water regularly, especially after coughing, sneezing or wiping your nose.

Causes of cough

Common causes of an acute cough

  • Upper respiratory tract infections. These will usually improve within 1 week, without any specific treatment, but milder symptoms may last up to 3 weeks
  • Lower Respiratory Tract Infections. These include Acute Bronchitis and chest infections
  • Asthma
  • Irritants in the air may irritate the airways

Subacute Cough (lasting between 3 and 8 weeks)

  • Airway hyper-responsiveness. Even after an infection of the airways settles, the airways may still be irritable and swollen, and this can cause the cough to continue for a few more weeks
  • Other uncommon airway infections such as TB

Common causes of a chronic cough (lasting over 8 weeks)

  • Postnasal drip. This can be caused by allergies, nasal polyps and infections. It is where mucous from the nose drips down the back of the throat, causing airway irritation
  • Acid reflux. This is where acid from the stomach passes up the gullet and into the airways, this can cause airway irritation
  • Asthma
  • Medication side effects
  • Smoking
Symptoms unsuitable for i-GP

There are certain symptoms that may be present with a cough that suggests you should see a doctor in person, as soon as possible, for a physical assessment and you may require further investigations.

  • If your cough has lasted longer than 3 weeks.
  • Coughing up blood.
  • If you have shortness of breath.
  • Any unexplained weight loss.
  • If you have night sweats.

If you develop any of the symptoms listed below, then you must seek urgent medical advice immediately. This can be from your GP, Out of Hours Service, Urgent care centre, Walk-in Centre, NHS 111. Call an ambulance or go to A&E if your symptoms are severe.

  • difficulty in breathing
  • chest pain
  • a severe headache
  • drowsiness or confusion
  • persistent vomiting
  • neck stiffness
  • non-blanching rash

Self-help for the symptoms

There are certain treatments you can try at home which may help you to manage your symptoms.

Pain medication 

  • such as paracetamol or ibuprofen. Read the leaflet that comes with the medication to check its suitability. This can help with pain and fever.

Cough Medicines

  • some people find that cough medicines can work well. Speak to your local pharmacist so they can help you select the correct one.

Over-the-counter Decongestant nasal sprays or drops

  • may help with a blocked nose to allow you to breathe through it better. Check with the pharmacist first to ensure they are suitable for you. Do not use them for more than a week. 

Saline (salt water) nasal drops

  • can help reduce the nasal discharge and unblock your nose.

Warm face packs

  • may help ease the sinus pain and help drain the mucus.

Drinking water

  • to keep hydrated and to prevent mild loss of water from the body (dehydration). Dehydration may develop if you have a high temperature and it can make a headache and tiredness much worse.

Steam Inhalation

  • there is not very much evidence that this helps but some people find it provides temporary relief.

Echinacea purpurea

  • Recent research has shown that some herbal remedies containing Echinacea purpurea might decrease the severity of your cough and associated symptoms.

A balanced and healthy diet

  • can also boost your immune system and quicken your recovery time. In particular, food rich in zinc has been suggested to help you overcome such infections. Regular exercise has also been shown to possibly reduce the incidence of upper respiratory tract infections and shorten the duration of your symptoms.
Antibiotic Guardianship

Antibiotics should be used responsibly and only when really necessary. Overuse and misuse of antibiotics can lead to antibiotic resistance. This is where the antibiotic becomes less effective at treating certain types of bacterial infection, so they do not work when needed. 

Antibiotics should be taken as prescribed, and it is important to complete the full course, this can reduce the chance of the bacteria developing an immunity to that antibiotic. It is important not to share antibiotics, and always take unused medication to your local pharmacy for disposal.

References

  1. British Thoracic Society (BTS) guideline Recommendations for the management of cough in adults[Morice et al, 2006]
  2. American College of Chest Physicians (ACCP) guideline An empiric integrative approach to the management of cough. [Pratter et al, 2006]
  3. National Institute for Health and Care Excellence (NICE) guideline Respiratory tract infections (self-limiting): prescribing antibiotics
  4. Institute for Clinical Systems Improvement guideline Diagnosis and Treatment of Respiratory Illness in Children and Adults (ICSI,2013)

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Please read all the information about Cough first.