{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T21:13:46Z","timestamp":1781298826056,"version":"3.54.1"},"reference-count":83,"publisher":"Oceanside Publications Inc.","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["allergy asthma proc"],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Chronic cough (CC), a cough that lasts &gt; 8 weeks, has an overall prevalence of 5\u201011% in adults, peaking between 60 and 80 years of age. Of the 15% of patients who remain undiagnosed or refractory to treatment, two thirds are women.  <jats:bold>Objective:<\/jats:bold>\n The objective was to present an updated evidence-based algorithmic approach for evaluating and managing CC, with emphasis on treatment modalities for refractory CC.  <jats:bold>Methods:<\/jats:bold> A literature search was conducted of medical literature data bases for guidelines, position\n papers, systematic reviews, and clinical trials from January 2022 to June 2023, on the evaluation and management of CC.  <jats:bold>Results:<\/jats:bold> The initial assessment should be limited to a detailed history, physical examination, chest radiograph, spirometry, exhaled nitric oxide, blood\n eosinophil count, and measurement of cough severity and quality of life by using validated instruments. The top diagnoses to consider are asthma, chronic obstructive pulmonary disease, nonasthmatic eosinophilic bronchitis, gastroesophageal reflux disease, and upper airway cough syndrome. Additional\n studies are only obtained when red flags are present or the patient fails to respond after avoidance of high-risk factors, e.g., smoking and angiotensin-converting enzyme inhibitors, and 4\u20106 weeks of empiric treatment for the most likely respiratory and gastrointestinal diseases. When\n diagnostic tests and\/or specific directed treatments fail to control CC, low-dose morphine (preferred), gabapentin, pregabalin, and\/or cough control therapy are recommended. Non-narcotic purinergic 2\u00d73 (P2\u00d73) receptor antagonists, gafapixant and campilixant, are currently being\n studied for CC.  <jats:bold>Conclusion:<\/jats:bold> For the evaluation and management of patients with CC, clinicians should use an algorithmic approach and identify \u201cred flags,\u201d reduce high-risk factors, and use empiric treatment for the five top diagnoses before extensive diagnostic\n testing. Current treatment for refractory cough is limited to symptomatic management.<\/jats:p>","DOI":"10.2500\/aap.2023.44.230059","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T04:34:07Z","timestamp":1698986047000},"page":"382-394","source":"Crossref","is-referenced-by-count":4,"title":["Evaluation and management of chronic cough in adults"],"prefix":"10.2500","volume":"44","author":[{"given":"Dana V.","family":"Wallace","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1355","reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.chest.2017.10.016","article-title":"Classification of cough as a symptom in adults and management algorithms: CHEST guideline and Expert Panel 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