A novel diagnostic algorithm for chronic and subacute cough

Lu, Ping; Zhou, Dan; Jin, Chengzhen

doi:10.1186/2049-6958-9-33

Cited by 4 publications

(2 citation statements)

References 26 publications

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“…Therefore, shortening the trials and educating the patients are imperative [29]. This study suggests that treating AS first [3] or AS and PNDS [30,31] simultaneously might be an alternative approach to the diagnosis of patients without typical symptoms or signs. However, further studies must be conducted for verification.…”

Section: Discussionmentioning

confidence: 99%

A novel diagnostic algorithm for chronic and subacute cough

Zhou

Jin

2014

Multidis Res Med

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Background: Cough remains the most common reason for patients to seek medical attention. We practised a novel diagnostic algorithm for chronic and subacute cough. Methods: Chronic and subacute cough patients with normal chest X-ray results and without respiratory tract infections in the preceding eight weeks were recruited. The patients were divided into two groups: Group A, patients with typical symptoms and signs of postnasal drip syndrome (PNDS), asthma syndromes (AS) and gastroesophageal reflux disease (GERD); Group B, patients without the typical symptoms and signs. The two groups received targeted or sequential empirical trials of therapy according to the algorithm. Results: Among the 524 patients available for analysis in Groups A and B, 436 (83.6%) were diagnosed to have PNDS (34.2%), AS (44.5%) and/or GERD (10.1%), among which 26 had two causes (6.0%) and 6 had three causes (1.4%). After empirical trials of therapy, 81.5% of the patients were diagnosed. The mean time for diagnosis was considerably shorter in Group A (13.1 ± 5.6 d) than in Group B (23.4 ± 7.2 d) (p < 0.01). The diagnosis rate of the first trial in Group A (54.1%) was significantly higher than that in Group B (28.6%, p < 0.01). Conclusions: The proposed algorithm is a promising and practical approach to diagnose chronic and subacute cough.

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Section: Discussionmentioning

confidence: 99%

A novel diagnostic algorithm for chronic and subacute cough

Zhou

Jin

2014

Multidis Res Med

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“…In fact, Lu and colleagues have demonstrated that overall therapeutic efficacy was comparable among the various protocols for empirically treating chronic and subacute cough. 22 …”

Section: Discussionmentioning

confidence: 99%

Efficacy of sequential three-step empirical therapy for chronic cough

Hang

et al. 2017

Ther Adv Respir Dis

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Background:Empirical three-step therapy has been proved in just one hospital. This study aimed to demonstrate applicability of the sequential empirical three-step therapy for chronic cough in different clinical settings.Methods:Sequential empirical three-step therapy was given to patients with chronic cough in one tertiary and three secondary care respiratory clinics. Recruiters were initially treated with methoxyphenamine compound as the first-step therapy, followed by corticosteroids as the second-step therapy and the combination of a proton-pump inhibitor and a prokinetic agent as the third-step therapy. The efficacy of the therapy was verified according to the changes in cough symptom score between pre- and post-treatment, and compared among the different clinics.Results:In total 155 patients in one tertiary clinic and 193 patients in secondary care clinics were recruited. The total dropout ratio is significantly higher in the secondary care clinics than that in the tertiary clinic (9.3% versus 3.2%, p = 0.023). The therapeutic success rate for cough was 38.7% at first-step therapy, 32.3% at second-step therapy and 20.0% at third-step therapy in the tertiary clinic, and comparable to corresponding 49.7%, 31.1% and 4.1% in secondary care clinics. Furthermore, the overall cough resolution rate was not significantly different (91.0% versus 85.0%, p = 0.091). However, the efficacy of the third-step therapy is much higher (20.0% versus 4.1%, p = 0.001) in the tertiary clinic than in the secondary care clinics.Conclusions:Sequential empirical three-step therapy is universally efficacious and useful for management of chronic cough in different clinical settings.

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