Chronic cough in childhood: A systematic review for practical guidance by the Italian Society of Pediatric Allergy and Immunology

Gian Luigi Marseglia, Sara Manti, Elena Chiappini, Ilaria Brambilla, Carlo Caffarelli, Mauro Calvani, Fabio Cardinale, Claudio Cravidi, Marzia Duse, Alberto Martelli, Domenico Minasi, Michele Miraglia Del Giudice, Giovanni Pajno, Diego G. Peroni, Maria Angela Tosca, Amelia Licari, Giorgio Ciprandi

Research output: Contribution to journalReview articlepeer-review


The current systematic review presented and discussed the most recent studies on pediatric chronic cough. In addition, the Italian Society of Pediatric Allergy and Immunology elaborated a comprehensive algorithm to guide the primary care approach to a pediatric patient with chronic cough.Several algorithms on chronic cough management have been adopted and validated in clinical practice; however, unlike the latter, we developed an algorithm focused on pediatric age, from birth until adulthood. Based on our findings, children and adolescents with chronic cough without cough pointers can be safely managed, initially using the watchful waiting approach and, successively, starting empirical treatment based on cough characteristics. Unlike other algorithms that suggest laboratory and instrumental investigations as a first step, this review highlighted the importance of a "wait and see" approach, consisting of parental reassurance and close clinical observation, also due to inter-professional collaboration and communication between general practitioners and specialists that guarantee better patient management, appropriate prescription behavior, and improved patient outcome. Moreover, the neonatal screening program provided by the Italian National Health System, which intercepts several diseases precociously, allowing to treat them in a very early stage, helps and supports a "wait and see" approach.Conversely, in the presence of cough pointers or persistence of cough, the patient should be tested and treated by the specialist. Further investigations and treatments will be based on cough etiology, aiming to intercept the underlying disease, prevent potentially irreversible tissue damage, and improve the general health of patients affected by chronic cough, as well as the quality of life of patients and their family.

Original languageEnglish
Pages (from-to)133-154
Number of pages22
JournalAllergologia et Immunopathologia
Issue number2
Publication statusPublished - 2021


  • adolescents
  • algorithm
  • children
  • chronic cough
  • diagnosis
  • dry cough
  • wet cough

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine


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