Thorax 61:i1-i24 doi:10.1136/thx.2006.065144
  • BTS Guidelines

Recommendations for the management of cough in adults

  1. A H Morice1,
  2. L McGarvey2,
  3. I Pavord3,
  4. on behalf of the British Thoracic Society Cough Guideline Group
  1. 1(Chairman), University of Hull, Castle Hill Hospital, Cottingham, UK
  2. 2(Co-Chair), The Queen’s University of Belfast, Belfast, UK
  3. 3(Co-Chair), University Hospitals of Leicester, Glenfield Hospital, Leicester, UK
  1. Correspondence to:
    Professor A H Morice
    University of Hull, Castle Hill Hospital, Cottingham, East Yorkshire HU16 5JQ, UK; a.h.morice{at}


    1.1 Background

    Patients with cough frequently present to clinicians working in both primary and secondary care.1,2 Acute cough, which often follows an upper respiratory tract infection, may be initially disruptive but is usually self-limiting and rarely needs significant medical intervention. Chronic cough is often the key symptom of many important chronic respiratory diseases but may be the sole presenting feature of a number of extrapulmonary conditions, in particular upper airway and gastrointestinal disease. Even with a clear diagnosis, cough can be difficult to control and, for the patient, can be associated with impaired quality of life.3,4 Sessions dedicated to cough at respiratory meetings are popular, suggesting that the pathophysiology, evaluation, and successful treatment of cough remain topics of keen interest to many medical practitioners.

    1.2 Need and purpose of BTS recommendations on the management of cough

    The American College of Chest Physicians (ACCP) and the European Respiratory Society (ERS)5,6 have each endorsed their own set of guidelines on the management of cough; however, criticism7 of their content and breadth suggest the need for further concise recommendations. The British Thoracic Society guidelines cover not only chronic cough but also acute cough and the organisational issues of cough clinics. International differences in delivery of respiratory health care and management strategies support the notion that such guidelines would be desirable. The British Thoracic Society Standards of Care Committee agreed to the development of a Working Group tasked with the job of producing a set of guidelines for the management of cough with the following key objectives:

    • To produce guidelines that are relevant to the clinical management of cough in both primary and secondary care.

    • To produce a critical review of the available literature.

    • To highlight cough as a clinical and research area of considerable importance.

    • To encourage extended cooperation between clinicians, scientists, and the pharmaceutical industry with the core aim …