jurnal
Copyright #ERS Journals Ltd 2002
European Respiratory Journal
ISSN 0903-1936
Eur Respir J 2002; 19: 6–7
DOI: 10.1183/09031936.02.00281002
Printed in UK – all rights reserved
EDITORIAL
Understanding cough
A.H. Morice*, J. Widdicombe#, P. Dicpinigaitis}, L. Groenkez
A recent meeting on antitussive strategies presented an opportunity to review current practice in the treatment of acute cough due to respiratory tract infection
(RTI). Multiple factors contribute to the present lack of consensus as to the appropriate management of this common condition. Firstly, terminology is problematic, both in relation to how cough itself is described, and in the classification of therapeutic agents for cough. Secondly, firm opinions regarding the efficacy, or lack thereof, of these agents, are often held without the foundation of properly executed clinical trials.
Traditionally cough is classified as either productive, i.e. producing mucus, usually with expectoration, or nonproductive (dry). However, studies which have elicited patients9 subjective descriptions of their symptoms during a RTI have revealed a commonlydescribed entity that being a productive cough of scant or no mucus, but associated with significant chest discomfort, including chest tightness and pain.
Such a cough is often referred to as a "chesty" cough.
Thus, the paradigm of cough in RTI may not reflect the clinical picture.
Similarly, the optimal therapeutic strategy for this common condition remains undetermined. This may at least partly be due to misconceptions as to which pathological process is affected by currently available treatments. In most general terms, medications used to treat cough are usually categorized as antitussive,
i.e. decreasing the sensitivity of the cough reflex, or protussive, i.e. enhancing the efficiency of cough.
Some clinicians continue to embrace the idea that antitussive therapy should be avoided in cough due to
RTI for fear that excessive
European Respiratory Journal
ISSN 0903-1936
Eur Respir J 2002; 19: 6–7
DOI: 10.1183/09031936.02.00281002
Printed in UK – all rights reserved
EDITORIAL
Understanding cough
A.H. Morice*, J. Widdicombe#, P. Dicpinigaitis}, L. Groenkez
A recent meeting on antitussive strategies presented an opportunity to review current practice in the treatment of acute cough due to respiratory tract infection
(RTI). Multiple factors contribute to the present lack of consensus as to the appropriate management of this common condition. Firstly, terminology is problematic, both in relation to how cough itself is described, and in the classification of therapeutic agents for cough. Secondly, firm opinions regarding the efficacy, or lack thereof, of these agents, are often held without the foundation of properly executed clinical trials.
Traditionally cough is classified as either productive, i.e. producing mucus, usually with expectoration, or nonproductive (dry). However, studies which have elicited patients9 subjective descriptions of their symptoms during a RTI have revealed a commonlydescribed entity that being a productive cough of scant or no mucus, but associated with significant chest discomfort, including chest tightness and pain.
Such a cough is often referred to as a "chesty" cough.
Thus, the paradigm of cough in RTI may not reflect the clinical picture.
Similarly, the optimal therapeutic strategy for this common condition remains undetermined. This may at least partly be due to misconceptions as to which pathological process is affected by currently available treatments. In most general terms, medications used to treat cough are usually categorized as antitussive,
i.e. decreasing the sensitivity of the cough reflex, or protussive, i.e. enhancing the efficiency of cough.
Some clinicians continue to embrace the idea that antitussive therapy should be avoided in cough due to
RTI for fear that excessive