October 4, 2025Open Access

Management of acute cough

Key Points

Most clinical guidelines do not support pharmacological interventions for acute cough, favoring non-pharmacological options instead.
The highest variation in guideline scores was for editorial independence, indicating diverse perspectives in guidelines about acute cough.
Assessment of 11 guidelines shows a mean applicability score of only 46%, underscoring the need for improved relevance.
Findings highlight the necessity for more high-quality clinical studies to enhance the reliability of cough management recommendations.

Abstract

Introduction: Cough is one of the main causes of demand for care in primary care, as it affects the patient’s quality of life. An acute cough is considered a self-limiting problem because it is of low severity and has a short latency period. Objective: The aim of this study was to evaluate the quality of clinical guidelines (CGs) for the treatment of acute cough. Methods: Searches were carried out on the websites of national and international institutions and organizations using the descriptors “cough,” “tos,” “practice guideline,” “guideline,” and “guide of clinical practice.” The selected guidelines were evaluated by four reviewers using the Appraisal of Guidelines for Research editorial independence (D6) had the highest score variation (0–98%); and applicability (D5) of guidelines had the lowest mean score, 46% (range 2–88%). Regarding interventions, most of the guidelines referred to pharmacological interventions as unnecessary and the most cited non-pharmacological intervention was menthol (ointment). Conclusions: Therefore, it is necessary to carry out more clinical studies of good quality so that the CGs can be revised, to make the recommendations more reliable.

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