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Cough duration is typically 1–3 weeks. If the cough persist beyond three weeks see: Chronic Cough
Patients must be symptomatic for a least one week before a diagnosis of bacterial sinusitis is made, because prior to that point bacterial overgrowth is unlikely.
The first step in diagnosing subacute cough is to determine whether the cough has followed a respiratory infection. If the cough does not appear to be postinfectious, it should be managed as if it were a chronic cough.
If the cough began with an upper respiratory tract infection and has lingered, it is usually considered a postinfectious cough. It is most probably caused by postnasal drip, upper airway irritation, mucus accumulation, or a manifestation of branchial hyperresponsiveness that may be associated with asthma. Ongoing allergen or irritant exposure, lingering effects of an infection, pneumonia, and acute exacerbation of chronic bronchitis should also be considered.
Patients suspected of being infected with B. pertussis (i.e., whooping cough) should have a nasopharyngeal swab for culture. Patients with confirmed whooping cough should receive macrolide antibiotics and should be isolated for five days beginning on the first day of treatment.
If the cough is not caused by bacterial sinusitis or Bordetella pertussis, treatment with inhaled ipratropium (Atrovent) should be initiated to attenuate the cough. If the cough persists, consider the use of inhaled corticosteroids. If the cough is severe, consider prescribing 30 to 40 mg of prednisone per day for a brief period. When other treatments fail, codeine or dextromethorphan (Delsym) should be considered.]
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