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One hundred coughs

Family practice case series

Correspondence to: Dr Graham Worrall, Dr William H. Newhook Memorial Health Centre, Whitbourne, NL A0B 3K0; telephone 709 759-2300; fax 709 759-2387; e-mail gworrall{at}mun.ca

OBJECTIVE To record the presentation, diagnosis, management, and outcome of acute coughs presenting in family practice.

DESIGN A case series of consecutive patients with acute cough as their main symptom.

SETTING Rural family practice clinic and walk-in centre.

PARTICIPANTS One hundred consecutive patients with cough, ages 1 to 90.

MAIN OUTCOME MEASURES Clinical diagnosis of the cause of the cough, management of cough, and whether patients returned for a second visit.

RESULTS Seventy-three patients had viral respiratory tract infections; 15 had asthma; 6 had influenza; 4 had pneumonia; and 2 had croup. Eighty-one patients needed no prescription medication; 13 were prescribed steroids or bronchodilators for asthma; and 6 were prescribed antibiotics. No prescriptions for cough suppressants or decongestants were written. Only 7 patients returned to the clinic; 2 were prescribed antibiotics, and the others had no change in treatment.

CONCLUSION Most patients with cough require reassurance rather than medications, as their cough is self-limiting. Of the minority that requires medication, twice as many will benefit from adjustment of asthma medication as from antibiotics.

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