The American College of Chest Physicians has issued an evidence-based guideline on appropriate treatments for unexplained chronic cough (UCC), including pharmacotherapy and speech pathology. The recommendations appear in the journal CHEST.

A total of 11 randomized controlled clinical trials on 570 patients and five systematic reviews were included, and the studies applied a range of descriptors and assessments to identify UCC. Studies on gabapentin and morphine indicated positive effects on cough-related quality of life, but only gabapentin was supported as a treatment recommendation. Inhaled corticosteroids (ICS) were not found to be effective for UCC after addressing intervention fidelity bias issues in the studies; esomeprazole was also not effective for UCC without features of gastroesophageal acid reflux. For non-pharmacological treatments, a multimodality speech pathology intervention led to improved cough severity.

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Based on this review, the authors concluded that the evidence supporting the diagnosis and management of UCC is limited and requires further study to set standards in terminology and methods of investigation with established criteria for intervention fidelity.

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