Don't ignore a chronic cough — but don't panic just because your cough lingers for more than three or four weeks. Most often, the puzzle can be solved without elaborate tests, and the problem can be corrected with simple treatments. In fact, you may be able to diagnose and treat yourself, especially if postnasal drip or gastroesophageal reflux is the culprit. Even so, your doctor can also help. In most cases, it won't take much more than a stethoscope and a treatment trial or two. But if your cough is accompanied by sputum production, bloody sputum, fever, weight loss, night sweats, breathlessness, undue fatigue, or chest pain, you should consult your doctor without delay. You can expect tests ranging from sputum exams and chest x-rays to pulmonary function tests, CT scans, and bronchoscopies. In most cases, you'll get good news — and you can expect to get a treatment program that will quiet your nagging cough.
Pertussis, the “90 day cough,” is problematic. In those older than 2 years, it only responds to treatment with antibiotics in the first 5 days of infection, up to 14 days if you read some sources who readily admit they are stretching the treatment window. From Hopkins: “However, once the paroxysmal stage has begun, antimicrobial therapy has
little effect on the course of illness and is indicated primarily to
limit the spread of the organism to others. Patients are no longer
infectious after 5 days of therapy.” Similarly,”According to the 2001 guidelines of the American College of Physicians for the treatment of uncomplicated acute bronchitis, antibiotic treatment is “not recommended, regardless of duration of cough.”
Seretide combination inhaler (contains the steroid fluticasone and longacting beta agonist salmeterol) to be given through a spacer device. The darker the inhaler, the higher the dose. Left hand has 50 mcg, middle one 125 mcg and right hand 250 mcg of fluticasone per puff, whilst they all contain the same 25 mcg dose of salmeterol.
Seretide combination inhaler (contains the steroid fluticasone and long acting beta agonist salmeterol) can also be given as a dry powder in a device called an accuhaler. It comes with different fluticasone strengths - 100, 250 and 500 mcg per puff, always with salmeterol at the same dose of 50 mcg per puff, but I only use the lowest dose as a dry powder.
Symbicort combination inhaler (contains the steroid budesonide and long acting beta agonist formoterol) can only be given as a dry powder in a device called a turbohaler. It comes in different combinations – 100/6, 200/6, and 400/12; the budesonide dose is 100 or 200, the formoterol dose 6 or 12 per puff. I only use the lower dose as a dry powder.