Management of cough in children

Identify and treat the cause of cough in children; see Causes of acute cough in children and Causes of chronic cough in children. For more detail on the diagnosis and management of chronic cough in children, including children-specific algorithms, see the European Respiratory Society guidelines.

Antibiotic therapy is not required for cough in children unless they have acute bacterial pneumonia or a bacterial cause of chronic cough (such as protracted bacterial bronchitis, pertussis, lung abscess or tuberculosis).

Honey has some evidence of benefit in children with cough; it may be trialled in children older than 12 months.

Cough and cold medicines for children have minimal, if any, evidence of efficacy, are costly, and can cause harm. The Australian Therapeutic Goods Administration (TGA) has advised that cough and cold medicines, including cough suppressants, antihistamines, decongestants and combination products, should not be given to children younger than 6 years. The Australian TGA advises that cough and cold medicines should only be given to children aged 6 to 11 years on the advice of a doctor, pharmacist or nurse practitioner. Caution should be used when treating children in this age group with cough and cold medicines; advise parents or carers of the minimal evidence of efficacy, and potential harms.

There is no evidence for the use of ‘salt therapy’ (salt caves, salt rooms or inhalation of salt) in treatment of cough in children.

If chronic cough persists despite treatment trial, refer to a paediatric respiratory physician.