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Acute cough due to acute bronchitis in immunocompetent adult outpatients: CHEST Expert Panel Report

Acute cough due to acute bronchitis in immunocompetent adult outpatients: CHEST Expert Panel Report
Acute cough due to acute bronchitis in immunocompetent adult outpatients: CHEST Expert Panel Report
BACKGROUND:
The evidence for the diagnosis and management of cough due to acute bronchitis in immunocompetent adult outpatients was reviewed as an update to the 2006 American College of Chest Physicians (ACCP) Evidence-Based Clinical Practice Guideline Cough due to Acute Bronchitis.

METHODS:
Acute bronchitis was defined as an acute lower respiratory tract infection manifested predominantly by cough with or without sputum production, lasting no more than 3 weeks with no clinical or any recent radiographic evidence to suggest an alternative explanation. Two clinical PICO (Population, Intervention, Comparison, Outcome) questions were addressed by systematic review in July 2017: firstly, the role of investigations beyond the clinical assessment of patients presenting with suspected acute bronchitis; and secondly, the efficacy and safety of prescribing medication for cough in acute bronchitis. An updated search was undertaken in May 2018.

RESULTS:
No eligible studies relevant to the first question were identified. For the second question, only one relevant study met eligibility criteria. This study found no difference in number of days with cough between patients treated with an antibiotic or an oral non-steroidal anti-inflammatory agent compared with placebo. Clinical suggestions and research recommendations were made based on the consensus opinion of the CHEST Expert Cough Panel.

CONCLUSION:
The panelists suggested that no routine investigations be ordered and no routine medications be prescribed in immunocompetent adult outpatients first presenting with cough due to suspected acute bronchitis, until such investigations and treatments have been shown to be safe and effective at making cough less severe or resolve sooner. If the cough due to suspected acute bronchitis persists or worsens, a reassessment and consideration of targeted investigations should be considered.
Bronchitis, Systematic Review, cough
0012-3692
1256-1265
Smith, Maeve
c17d46fe-c516-4244-b0f1-05d330e8bf35
Lown, Mark
4742d5f8-bcf3-4e0b-811c-920e7d010c9b
Singh, Sonal
14ef2007-875c-48f3-bbd6-11b2bfd42ece
Ireland, Belinda
0f8a2197-6f2a-41b7-b15f-faf9b49dff1c
Hill, Adam
59b66262-0917-4b90-99a7-31de9a971242
Linder, Jeff
44d0b658-f59c-4bd5-bbaa-10bc2022188d
Irwin, Richard
6424929e-c43a-4b5e-a090-f2872cfe2b94
CHEST Expert Cough Panel
Smith, Maeve
c17d46fe-c516-4244-b0f1-05d330e8bf35
Lown, Mark
4742d5f8-bcf3-4e0b-811c-920e7d010c9b
Singh, Sonal
14ef2007-875c-48f3-bbd6-11b2bfd42ece
Ireland, Belinda
0f8a2197-6f2a-41b7-b15f-faf9b49dff1c
Hill, Adam
59b66262-0917-4b90-99a7-31de9a971242
Linder, Jeff
44d0b658-f59c-4bd5-bbaa-10bc2022188d
Irwin, Richard
6424929e-c43a-4b5e-a090-f2872cfe2b94

Smith, Maeve, Lown, Mark, Singh, Sonal, Ireland, Belinda, Hill, Adam, Linder, Jeff and Irwin, Richard , CHEST Expert Cough Panel (2020) Acute cough due to acute bronchitis in immunocompetent adult outpatients: CHEST Expert Panel Report. Chest, 157 (5), 1256-1265, [2020.01.044]. (doi:10.1016/j.chest.2020.01.044).

Record type: Review

Abstract

BACKGROUND:
The evidence for the diagnosis and management of cough due to acute bronchitis in immunocompetent adult outpatients was reviewed as an update to the 2006 American College of Chest Physicians (ACCP) Evidence-Based Clinical Practice Guideline Cough due to Acute Bronchitis.

METHODS:
Acute bronchitis was defined as an acute lower respiratory tract infection manifested predominantly by cough with or without sputum production, lasting no more than 3 weeks with no clinical or any recent radiographic evidence to suggest an alternative explanation. Two clinical PICO (Population, Intervention, Comparison, Outcome) questions were addressed by systematic review in July 2017: firstly, the role of investigations beyond the clinical assessment of patients presenting with suspected acute bronchitis; and secondly, the efficacy and safety of prescribing medication for cough in acute bronchitis. An updated search was undertaken in May 2018.

RESULTS:
No eligible studies relevant to the first question were identified. For the second question, only one relevant study met eligibility criteria. This study found no difference in number of days with cough between patients treated with an antibiotic or an oral non-steroidal anti-inflammatory agent compared with placebo. Clinical suggestions and research recommendations were made based on the consensus opinion of the CHEST Expert Cough Panel.

CONCLUSION:
The panelists suggested that no routine investigations be ordered and no routine medications be prescribed in immunocompetent adult outpatients first presenting with cough due to suspected acute bronchitis, until such investigations and treatments have been shown to be safe and effective at making cough less severe or resolve sooner. If the cough due to suspected acute bronchitis persists or worsens, a reassessment and consideration of targeted investigations should be considered.

Text
PIIS0012369220303299 - Accepted Manuscript
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More information

Accepted/In Press date: 9 January 2020
e-pub ahead of print date: 21 February 2020
Keywords: Bronchitis, Systematic Review, cough

Identifiers

Local EPrints ID: 438360
URI: http://eprints.soton.ac.uk/id/eprint/438360
ISSN: 0012-3692
PURE UUID: 09ce685f-248c-4a97-8c26-3b255be7ce0b
ORCID for Mark Lown: ORCID iD orcid.org/0000-0001-8309-568X

Catalogue record

Date deposited: 06 Mar 2020 17:33
Last modified: 09 Jan 2022 08:09

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Contributors

Author: Maeve Smith
Author: Mark Lown ORCID iD
Author: Sonal Singh
Author: Belinda Ireland
Author: Adam Hill
Author: Jeff Linder
Author: Richard Irwin
Corporate Author: CHEST Expert Cough Panel

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