Differential diagnosis of cough in paediatric practice: The role of combination therapy

Cough is an interdisciplinary problem and there are various possible reasons for its occurrence: pulmonological, cardiological, otolaryngological, gastroenterological, neurological and others. Despite the large number of causes of cough in pediatric practice, cough is most often caused by acute respiratory viral infections of both the upper and lower respiratory tract. At the same time, in the differential diagnosis of acute cough, it is important to make sure of its connection with infection (fever, presence of catarrhal syndrome). This article discusses differential diagnostic criteria for cough in pediatric practice in various diseases. Rational antitussive therapy is based on: establishing a diagnosis of the disease; analysis of cough characteristics; intensity of the cough act, its duration; its impact on the patient’s condition, and also taking into account the presence of obstructive respiratory syndrome. The use of combined mucoactive drugs that can have a complex effect on various pathogenetic mechanisms is one of the important areas in mucolytic cough therapy. Such an effective combination drug is a drug based on salbutamol, bromhexine and guaifenesin. Salbutamol promotes relaxation of the smooth muscles of the bronchi, which can prevent or eliminate bronchial obstruction; bromhexine has a mucolytic effect, which is indicated for respiratory infections occurring with hypersecretion of viscous sputum; guaifenesin is a mucoactive drug that liquefies sputum in the respiratory tract and helps increase cough productivity. These components have a synergistic effect on various pathogenetic mechanisms of inflammatory processes in the respiratory tract, which are accompanied by a cough with difficult sputum and an obstructive component.