S2k-Leitlinie Fachärztliche Diagnostik und Therapie von erwachsenen Patienten mit Husten

Zusammenfassung

Die vorliegende 4. Ausgabe der deutschen fachärztlichen S2k-Leitlinie wurde im Auftrag der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin unter Teilnahme von – durch die jeweiligen Gesellschaften akkreditierten – Allergologen, HNO-Ärzten, Gastroenterologen, Internisten, Logopäden und Physiotherapeuten sowie eines Patientenvertreters unter Leitung eines Systematikers erstellt. Sie soll die S3-Husten-Leitlinie der Deutschen Gesellschaft für Allgemeinmedizin (DEGAM) im Hinblick auf spezielle Fragestellungen ergänzen.

Sie hat gegenüber den früheren Versionen 1–3, die einen Monografie-Charakter hatten, ein völlig neues Konzept. In einem modifizierten Delphi-Verfahren erarbeiteten die Autoren 12 Schlüsselfragen, die in der Leitlinienkonferenz beantwortet und auf der Basis der vorliegenden Evidenz abgestimmt und nach Soll- (stark), Sollte- (schwache) oder Kann-Empfehlung (keine ausreichende Evidenz/Erfahrung) graduiert worden waren. Anschließend wurde ein kurzer wissenschaftlicher Hintergrund zu den jeweiligen Fragen durch sachverständige Gruppen der Autoren erarbeitet. Teilweise neue Diagnostik-Algorithmen wurden für den akuten, subakuten und chronischen Husten erstellt.

Durch den deutlich reduzierten Umfang und bessere Übersicht ist die Leitlinie für die tägliche Praxis besser anwendbar. Sie wurde außerdem in die Smartphone App Leila Pro aufgenommen und ist mit den dortigen Komfortfunktionen abrufbar.

Die Leitlinie enthält folgende Schlüsselfragen:

 1. Wie wird Husten klassifiziert?

 2. Was sind die häufigsten Ursachen für den akuten und subakuten Husten?

 3. Welche Alarmzeichen („red flags“) erfordern eine unverzügliche ausführliche Diagnostik und ggf. Therapie?

 4. Was sind häufige Ursachen für den chronischen Husten?

 5. Ist die SARS-CoV-2-Infektion bei der Abklärung des Hustens relevant?

 6. Was ist chronisch refraktärer oder chronisch idiopathischer Husten?

 7. Können chronische Erkrankungen der oberen Atemwege chronischen Husten auslösen?

 8. Kann gastroösophagealer Reflux chronischen Husten verursachen?

 9. Kann eine bronchiale Hyperreagibilität (BHR) oder eine eosinophile Entzündung der Bronchien (NAEB) ohne klassisches Asthma für den chronischen Husten verantwortlich sein?

10. Gibt es Medikamente, die chronischen Husten verursachen können?

11. Welche Basisdiagnostik und personalisierte Diagnostik sind erforderlich, um den chronischen Husten abzuklären?

12. Welche nicht-medikamentösen und medikamentösen Therapien gibt es für den Husten?

Abstract

This is the 4^th edition of the Cough Guidelines of the German Respiratory Society written by respiratory, gastroenterology, ear-nose-throat specialists, including respiratory physiotherapists and speech pathology specialists; importantly, a patient representative was also involved.

Compared with earlier versions we used a new methodology: after discussion in the guidelines group, we asked and answered the 12 most important and most frequent “key” questions regarding the clinical practice. The extent of the guideline could thus be significantly reduced.

We added a short scientific background to each of the answers including the most recent references. The recommendations and statements were created in consensus and graded as strong, or weak. If sufficient literature was not available, we suggested discussing joint decisions with the patient.

The 12 key questions are as follows:

– Key question 1: The classification of cough (acute, i. e. up to three weeks duration; chronic, i. e. after 8 weeks duration and subacute in between) did not change, but we added “cough with or without expectoration as an additional classification aspect with therapeutic consequences.

– Key question 2: Acute and subacute cough are mostly (but not exclusively) due to the common cold. They are the first or second most frequent symptom prompting patients to seek medical (or pharmacist’s) care. Antibiotic therapy is strongly discouraged for common cold

– Key question 3: We defined “Red flags” for mandatory immediate diagnostic for acute cough, which usually does not require such diagnostic procedures

– Key question 4: Chronic cough overview of the most common causes for

– Key question 5: Cough in acute SARS-CoV-2 infection and in long COVID

– Key question 6: Refractory chronic cough and idiopathic chronic cough, two recently established entities were explained more in detail

– Key question 7: To upper airway cough syndrome

– Key question 8: Gastro-oesophageal-reflux-related cough

– Key question 9: Cough-variant asthma and non-asthmatic eosinophilic bronchitis

– Key question 10: Overview of drugs causing cough

– Key question 11: Basic and personalized (due to the individual history) diagnostic procedures for patients with cough

– Key question 12: Physiotherapy, speech therapy and pharmacotherapy for cough

Publication History

Article published online:
12 May 2025

• Literatur

• 1 Kardos P, Dinh QT, Fuchs KH. et al. Leitlinie der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin zur Diagnostik und Therapie von erwachsenen Patienten mit Husten. Pneumologie 2019; 73: 143-180
• 2 Krüger K, Gehrke-Beck S, Holzinger F. et al. Akuter und chronischer Husten S3-Leitlinie DEGAM. AWMF; 2021. https://register.awmf.org/assets/guidelines/053-013l_S3_akuter-und-chronischer-Husten_2022-01.pdf
• 3 https://www.paediatrische-pneumologie.eu/GPP
• 4 Irwin RS, French CL, Chang AB. et al. Classification of Cough as a Symptom in Adults and Management Algorithms: CHEST Guideline and Expert Panel Report. Chest 2018; 153: 196-209
• 5 Morice AH, Millqvist E, Bieksiene K. et al. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. Eur Respir J 2020; 55: 1901136
• 6 Parker SM, Smith JA, Birring SS. et al. British Thoracic Society Clinical Statement on chronic cough in adults. Thorax 2023; 78: s3-s19
• 7 Marchant JM, Chang AB, Kennedy E. et al. Cough in Children and Adults: Diagnosis, Assessment and Management (CICADA). Summary of an updated position statement on chronic cough in Australia. Medical Journal of Australia 2024; 220: 35-45
• 8 Jung N, Koop H, Riessen R. et al. ["Choosing wisely" in infectious diseases: Overuse of antibiotics – too few vaccinations]. Internist (Berl) 2016; 57: 527-531
• 9 McGarvey LP, Birring SS, Morice AH. et al. Efficacy and safety of gefapixant, a P2X3 receptor antagonist, in refractory chronic cough and unexplained chronic cough (COUGH-1 and COUGH-2): results from two double-blind, randomised, parallel-group, placebo-controlled, phase 3 trials. The Lancet 2022; 399: 909-923
• 10 Brister D, Khan S, Abraham T. et al. Burden of Disease Associated with Refractory and Unexplained Chronic Cough in Canada: Results from a National Survey. Lung 2024; 202: 415-424
• 11 Smyrnios NA, Irwin RS, Curley FJ. Chronic Cough With A History Of excessive sputum production. The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy. Chest 1995; 108: 991-997
• 12 King J, Digby JW, Hennessey S. et al. Productive Cough, a Forgotten Phenotype of Refractory Chronic Cough. Respiratory Medicine and Research 2024; 86: 101106
• 13 Satia I, Mayhew AJ, Sohel N. et al. Impact of productive and dry chronic cough on mortality in the Canadian Longitudinal Study on Aging (CLSA). J Thorac Dis 2022; 14: 5087-5096
• 14 Kardos P, Malek FA. Common Cold – an Umbrella Term for Acute Infections of Nose, Throat, Larynx and Bronchi. Pneumologie 2017; 71: 221-226
• 15 Malesker MA, Callahan-Lyon P, Ireland B. et al. Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold: CHEST Expert Panel Report. Chest 2017; 152: 1021-1037
• 16 Morice A, Kardos P. Comprehensive evidence-based review on European antitussives. BMJ Open Respiratory Research 2016; 3: e000137
• 17 Matthys H, de Mey C, Carls C. et al. Efficacy and tolerability of myrtol standardized in acute bronchitis. A multi-centre, randomised, double-blind, placebo-controlled parallel group clinical trial vs. cefuroxime and ambroxol. Arzneimittelforschung 2000; 50: 700-711
• 18 Schaefer A, Kehr MS, Giannetti BM. et al. A randomized, controlled, double-blind, multi-center trial to evaluate the efficacy and safety of a liquid containing ivy leaves dry extract (EA 575®) vs. placebo in the treatment of adults with acute cough. Pharmazie 2016; 71: 504-509
• 19 Fischer J, Dethlefsen U. Efficacy of cineole in patients suffering from acute bronchitis: a placebo-controlled double-blind trial. Cough 2013; 9: 25
• 20 Gillissen A, Wittig T, Ehmen M. et al. A multi-centre, randomised, double-blind, placebo-controlled clinical trial on the efficacy and tolerability of GeloMyrtol(R) forte in acute bronchitis. Drug Res (Stuttg) 2013; 63: 19-27
• 21 Timmer A, Gunther J, Motschall E. et al. Pelargonium sidoides extract for treating acute respiratory tract infections 5. Cochrane Database Syst Rev 2013; 10: CD006323
• 22 Kemmerich B, Eberhardt R, Stammer H. Efficacy and tolerability of a fluid extract combination of thyme herb and ivy leaves and matched placebo in adults suffering from acute bronchitis with productive cough. A prospective, double-blind, placebo-controlled clinical trial. Arzneimittelforschung 2006; 56: 652-660
• 23 Kemmerich B. Evaluation of efficacy and tolerability of a fixed combination of dry extracts of thyme herb and primrose root in adults suffering from acute bronchitis with productive cough. A prospective, double-blind, placebo-controlled multicentre clinical trial. Arzneimittelforschung 2007; 57: 607-615
• 24 Schaefer A, Ludwig F, Giannetti BM. et al. Efficacy of two dosing schemes of a liquid containing ivy leaves dry extract EA 575 versus placebo in the treatment of acute bronchitis in adults. ERJ Open Res 2019; 5: 00019-2019
• 25 Wang DY, Ghoshal AG, Razak Bin Abdul MA. et al. Cough as a Key Symptom in Asthma, Allergic Rhinitis, Copd and Rhinosinusitis and Its Impact in Asia. Value Health 2014; 17: A776-A777
• 26 Tajiri T, Toriyama A, Sokai A. et al. [The Causes of Acute Cough: A Single-Center Study in Japan]. Arerugi 2018; 67: 46-52
• 27 Lommatzsch M, Criee CP, de Jong CCM. et al. [Diagnosis and treatment of asthma: a guideline for respiratory specialists 2023 – published by the German Respiratory Society (DGP) e. V.]. Pneumologie 2023; 77: e3
• 28 Ewig S, Kolditz M, Pletz M. et al. Behandlung von erwachsenen Patienten mit ambulant erworbener Pneumonie – Update 2021. Pneumologie 2021; 75: 665-729
• 29 Wang SSY, Paulus F, Teoh CM. Pneumothorax, More Than Meets the Eye. A Woman with Acute Intermittent Pleuritic Pain Associated with Dyspnea and a Dry Cough after a Flight. Ann Am Thorac Soc 2021; 18: 347-352
• 30 Brunnee T, Graf K, Kastens B. et al. Bronchial hyperreactivity in patients with moderate pulmonary circulation overload. Chest 1993; 103: 1477-1481
• 31 Brandon N. Premature Atrial Contraction as an Etiology for Cough. Chest 2008; 133: 828
• 32 Baron SB, Huang SK. Cough syncope presenting as Mobitz type II atrioventricular block--an electrophysiologic correlation. Pacing Clin Electrophysiol 1987; 10: 65-69
• 33 Daher A, Balfanz P, Cornelissen C. et al. Follow up of patients with severe coronavirus disease 2019 (COVID-19): Pulmonary and extrapulmonary disease sequelae. Respir Med 2020; 174: 106197
• 34 Weinberger R, Riffelmann M, Kennerknecht N. et al. Long-lasting cough in an adult German population: incidence, symptoms, and related pathogens. Eur J Clin Microbiol Infect Dis 2018; 37: 665-672
• 35 Holt E. Pertussis outbreak in Czech Republic. Lancet Infect Dis  2024; 24: e359
• 36 Nordholm AC, Emborg HD, Norgaard SK. et al. Pertussis epidemic in Denmark, August 2023 to February 2024. Euro surveillance: bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 2024; 29: 2400160
• 37 Surmann B, Witte J, Batram M. et al. Epidemiology of Pertussis and Pertussis-Related Complications in Adults: A German Claims Data Analysis. Infectious Diseases and Therapy 2024; 13: 385-399
• 38 Fokkens WJ, Lund VJ, Hopkins C. et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology 2020; 58: 1-464
• 39 Braman SS. Chronic cough due to acute bronchitis: ACCP evidence-based clinical practice guidelines. Chest 2006; 129: 95S-103S
• 40 Lai K, Lin L, Liu B. et al. Eosinophilic airway inflammation is common in subacute cough following acute upper respiratory tract infection. Respirology 2016; 21: 683-688
• 41 Gillissen A, Richter A, Oster H. Clinical efficacy of short-term treatment with extra-fine HFA beclomethasone dipropionate in patients with post-infectious persistent cough. J Physiol Pharmacol 2007; 58 (Suppl. 05) 223-232
• 42 S3-Leitlinie akuter und chronischer Husten der Deutschen Gesellschaft für Allgemeinmedizin und Familienmedizin. AWMF-Register-Nr. 053-013.
• 43 Deslee G, Burgel PR, Escamilla R. et al. Impact of current cough on health-related quality of life in patients with COPD. Int J Chron Obstruct Pulmon Dis 2016; 11: 2091-2097
• 44 Frye BC, Potasso L, Farin E. et al. Abnormal FeV1 and body mass index are associated with impaired cough-related quality of life in sarcoidosis patients. Respir Med 2021; 188: 106600
• 45 Tashkin DP, Volkmann ER, Tseng C-H. et al. Improved cough and cough-specific quality of life in patients treated for scleroderma-related interstitial lung disease (ssc-ild): Results of scleroderma lung study ii. Chest 2017; 151: 813-820
• 46 Chamberlain SA, Garrod R, Douiri A. et al. The impact of chronic cough: a cross-sectional European survey. Lung 2015; 193: 401-408
• 47 Lai K, Satia I, Song W-J. et al. Cough and cough hypersensitivity as treatable traits of asthma. Lancet Respir Med 2023; 11: 650-662
• 48 Dicpinigaitis PV. Effect of tobacco and electronic cigarette use on cough reflex sensitivity. Pulm Pharmacol Ther 2017; 47: 45-48
• 49 Ekici A, Ileri S, Aslan H. et al. Troublesome cough as the sole manifestation of pulmonary embolism. Respir Med Case Rep 2019; 28: 100861
• 50 Aleva FE, Voets LWLM, Simons SO. et al. Prevalence and localization of pulmonary embolism in unexplained acute exacerbations of copd: A systematic review and meta-analysis. Chest 2017; 151: 544-554
• 51 Burgel PR, Burnet E, Regard L. et al. The Changing Epidemiology of Cystic Fibrosis: The Implications for Adult Care. Chest 2023; 163: 89-99
• 52 Chandel A, Pak K, Dooley S. et al. Decades of cough: delayed recognition of atypical cystic fibrosis in an adult patient. J Roy Soc med 2020; 11: 1-4
• 53 Bell SC, Mall MA, Guiterrez H. et al. The Lancet Respiratory Medicine Commission on the future of care of cystic fibrosis. Lancet Respir Med 2020; 8: 65-124
• 54 Su J, Fang Y, Meng Y. et al. Effect of Continuous Positive Airway Pressure on Chronic Cough in Patients with Obstructive Sleep Apnea and Concomitant Gastroesophageal Reflux. Nat Sci Sleep 2022; 14: 13-23
• 55 Sundar KM, Stark AC, Dicpinigaitis P. Chronic Cough and Obstructive Sleep Apnea. Sleep Med Clin 2024; 19: 239-251
• 56 Vertigan AE. Somatic cough syndrome or psychogenic cough – what is the difference?. J Thorac Dis 2017; 9: 831-838
• 57 Lai K, Peng W, Zhan W. et al. Clinical characteristics in adult patients with somatic cough syndrome. Therapeutic Advances in Respiratory Disease 2022; 16: 17534666221092993
• 58 Zacharasiewicz A, Shields MD. Habit-tic cough: Presentation and outcome with simple reassurance. Pediatr Pulmonol 2018; 53: 266-268
• 59 Jacobs LG, Gourna Paleoudis E, Lesky-Di Bari D. et al. Persistence of symptoms and quality of life at 35 days after hospitalization for COVID-19 infection. PLoS ONE 2020; 15: e0243882
• 60 Hopff SM, Appel KS, Miljukov O. et al. Comparison of post-COVID-19 symptoms in patients infected with the SARS-CoV-2 variants delta and omicron—results of the Cross-Sectoral Platform of the German National Pandemic Cohort Network (NAPKON-SUEP). Infection 2024; 52: 2253-2267
• 61 Wong AW, Shah AS, Johnston JC. et al. Patient-reported outcome measures after COVID-19: a prospective cohort study. Eur Respir J 2020; 56: 2003276
• 62 Thaweethai T, Jolley SE, Karlson EW. et al. Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection. JAMA 2023; 329: 1934
• 63 Stewart I, Jacob J, George PM. et al. Residual Lung Abnormalities Following COVID-19 Hospitalization: Interim Analysis of the UKILD Post-COVID Study. Am J Respir Crit Care Med 2023; 207: 693-703
• 64 Koczulla AR, Ankermann T, Behrends U. et al. S1-Leitlinie Long-/Post-COVID. Pneumologie 2022; 76: 855-907
• 65 Smith JA, Satia I, Badri H. et al. Mini-review: Hypertussivity and allotussivity in chronic cough endotypes. Neurosci Lett 2022; 792: 136934
• 66 Virchow JC, Li VW, Fonseca E. et al. Chronic cough in Germany: results from a general-population survey. ERJ Open Res 2022; 8: 00420-2021
• 67 Backer V, Porsborg A, Hansen V. et al. A register-based study: cough – a frequent phenomenon in the adult population. BMC Pulm Med 2022; 22: 426
• 68 Zeiger RS, Xie F, Schatz M. et al. Prevalence and Characteristics of Chronic Cough in Adults Identified by Administrative Data. Perm J 2020; 24: 1-3
• 69 Morice AH, Faruqi S, Wright CE. et al. Cough hypersensitivity syndrome: a distinct clinical entity. Lung 2011; 189: 73-79
• 70 Morice A, Dicpinigaitis P, McGarvey L. et al. Chronic cough: new insights and future prospects. European Respiratory Review 2021; 30: 210127
• 71 Haque RA, Usmani OS, Barnes PJ. Chronic Idiopathic Cough: A Discrete Clinical Entity?. Chest 2005; 127: 1710-1713
• 72 Macedo P, Zhang Q, Saito J. et al. Analysis of bronchial biopsies in chronic cough. Respir Med 2017; 127: 40-44
• 73 Vertigan AE, Bone SL, Gibson PG. Laryngeal sensory dysfunction in laryngeal hypersensitivity syndrome. Respirology 2013; 18: 948-956
• 74 Hilton E, Marsden P, Thurston A. et al. Clinical features of the urge-to-cough in patients with chronic cough. Respir Med 2015; 109: 701-707
• 75 Millqvist E, Bende M. Role of the upper airways in patients with chronic cough. Curr Opin Allergy Clin Immunol 2006; 6: 7-11
• 76 Watelet JB, Van Zele T, Brusselle G. Chronic cough in upper airway diseases. Respir Med 2010; 104: 652-657
• 77 Stuck BA, Beule A, Jobst D. et al. Leitlinie „Rhinosinusitis“ – Langfassung. HNO 2018; 66: 38-74
• 78 Hellings PW, Klimek L, Cingi C. et al. Non-allergic rhinitis: Position paper of the European Academy of Allergy and Clinical Immunology. Allergy 2017; 72: 1657-1665
• 79 O’Hara J, Jones NS. "Post-nasal drip syndrome": most patients with purulent nasal secretions do not complain of chronic cough. Rhinology 2006; 44: 270-273
• 80 Smith JA, Woodcock A. Chronic Cough. N Engl J Med 2016; 375: 1544-1551
• 81 Dillenhöfer S, Hinrichs B, Kohl A. et al. Die induzierbare laryngeale Obstruktion (ILO) – Ursachen, klinische Präsentation, Diagnostik und Therapie Positionspaper der Arbeitsgruppe „Dysfunktionelle Respiratorische Symptome“ der Gesellschaft für Pädiatrische Pneumologie (GPP). Monatsschr Kinderheilkd 2021; 169: 1075-1082
• 82 Christensen PM, Heimdal JH, Christopher KL. et al. ERS/ELS/ACCP 2013 international consensus conference nomenclature on inducible laryngeal obstructions. Eur Respir Rev 2015; 24: 445-450
• 83 Bardin P. VCD/ILO: Seeing and believing. Respirology 2024; 29: 633-634
• 84 Roksund OD, Heimdal JH, Clemm H. et al. Exercise inducible laryngeal obstruction: diagnostics and management. Paediatr Respir Rev 2017; 21: 86-94
• 85 Weise S, Kardos P, Pfeiffer-Kascha D. et al. Empfehlungen zur Atemphysiotherapie. 3. Aufl. Deutsche Atemwegsliga u. Dustri-Verlag Dr. Karl Feistle; 2019. ISBN: 978-3-87185-545-0 14
• 86 Giancolo EAL, Eichler M, Muensterer O. et al. Methoden zur Bewertung in Beobachtungsstudien Teil 27 zur Bewertung wissenschaftlicher Publikationen. Dtsch Arztebl Int 2020; 117: 101-107
• 87 Madisch A, Koop H, Miehlke S. et al. S2k-Leitlinie Gastroösophageale Refluxkrankheit und eosinophile Ösophagitis der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS). Z Gastroenterol 2023; 61: 862-933
• 88 Chen JW, Vela MF, Peterson KA. et al. AGA clinical practice update on the diagnosis and management of extraesophageal gastroesophageal reflux disease: expert review. Clin Gastroenterol Hepatol 2023; 21: 1414-1421
• 89 Morice AH. Epidemiology of cough. Pulm Pharmacol Ther 2002; 15: 253-259
• 90 Vakil N, van Zanten SV, Kahrilas P. et al. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006; 101: 1900-1920
• 91 Smith JA, Decalmer S, Kelsall A. et al. Acoustic cough-reflux associations in chronic cough: potential triggers and mechanisms. Gastroenterology 2010; 139: 754-762
• 92 Broers C, Tack J, Pauwels A. Review article: gastro-oesophageal reflux disease in asthma and chronic obstructiive pulmonary disease. Aliment Pharmacol Ther 2018; 47: 1172-1178
• 93 Herregods TVK, Pauwels A, Jafari J. et al. Determinants of reflux-induced chronic cough. Gut 2017; 66: 2057-2062
• 94 Kahrilas PJ, Smith JA, Dicpimigaitis PV. A causal relationship between cough and gastroesophageal reflux disease (GERD) has been established: a pro/con debate. Lung 2014; 192: 39-46
• 95 Wu J, Ma Y, Chen Y. GERD-related chronic cough: possible mechanisms, diagnosis and treatment. Front Physiol 2022; 123: 1005404
• 96 Frankel A, Ong HS, Smithers BM. et al. Efficacy of laparoscopic fundoplication in patients with chronic cough and gastro-oesophageal reflux. Esophagus 2023; 20: 170-177
• 97 Liu J, Hu Z, Liang Y. et al. Efficacy and safety of fundoplication in treating gastroesophageal reflux related chronic cough. A meta-analysis. Asian J Surg 2024; 47: 4281-4286
• 98 Chang AB, Lasserson TJ, Kiljander TO. et al. Systematic review and meta-analysis of randomised controlled trials of gastro-oesophageal reflux interventions for chronic cough associated with gastro-oesophageal reflux. BMJ 2006; 332: 11-17
• 99 Chang AB, Lasserson TJ, Gaffney J. et al. Gastro-oesophageal reflux treatment for prolonged non-specidic cough in children and adults. Cochrane Database Syst Rev 2011; 2011: CD004823
• 100 Kahrilas PJ, Howden CW, Hughes N. et al. Response of chronic cough to acid-suppressive therapy in patients with gastroesophageal reflux disease. Chest 2013; 143: 605-612
• 101 Gyawali CP, Yadlapati R, Fass R. et al. Updates to the modern diagnosis of GERD: Lyon consensus 2.0. Gut 2024; 73: 361-371
• 102 Leynaert B, Sunyer J, Garcia-Esteban R. et al. Gender differences in prevalence, diagnosis and incidence of allergic and non-allergic asthma: a population-based cohort study. Thorax 2012; 67: 625-631
• 103 Nowak D, Heinrich J, Jorres R. et al. Prevalence of respiratory symptoms, bronchial hyperresponsiveness and atopy among adults: west and east Germany. Eur Respir J 1996; 9: 2541-2552
• 104 Niimi A, Ohbayashi H, Sagara H. et al. Cough variant and cough-predominant asthma are major causes of persistent cough: a multicenter study in Japan. J Asthma 2013; 50: 932-937
• 105 Corrao WM, Braman SS, Irwin RS. Chronic Cough As The Sole Presenting manifestation of bronchial asthma. N Engl J Med 1979; 300: 633-637
• 106 Niimi A. Narrative Review: how long should patients with cough variant asthma or non-asthmatic eosinophilic bronchitis be treated?. J Thorac Dis 2021; 13: 3197-3214
• 107 Niimi A, Amitani R, Suzuki K. et al. Eosinophilic inflammation in cough variant asthma. Eur Respir J 1998; 11: 1064-1069
• 108 Matsumoto H, Niimi A, Tabuena RP. et al. Airway Wall Thickening in Patients With Cough Variant Asthma and Nonasthmatic Chronic Cough. Chest 2007; 131: 1042-1049
• 109 Chen LC, Zeng GS, Wu LL. et al. Diagnostic value of FeNO and MMEF for predicting cough variant asthma in chronic cough patients with or without allergic rhinitis. J Asthma 2021; 58: 326-333
• 110 Gibson PG, Dolovich J, Denburg J. et al. Chronic Cough: Eosinophilic Bronchitis Without Asthma. Lancet 1989; 1: 1346-1348
• 111 Huang J, Liu J, Xian Y. et al. Elevated Circulating CD4(+)CD25(+)CD127(-/low) Regulatory T Cells in Patients with Non-asthmatic Eosinophilic Bronchitis. Lung 2020; 198: 491-497
• 112 Zhan C, Xu R, Liu J. et al. Increased Sputum IL-17A Level in Non-asthmatic Eosinophilic Bronchitis. Lung 2018; 196: 699-705
• 113 Pratter MR. Overview of common causes of chronic cough: ACCP evidence-based clinical practice guidelines. Chest 2006; 129: 59S-62S
• 114 Diab N, Patel M, O'Byrne P. et al. Narrative Review of the Mechanisms and Treatment of Cough in Asthma, Cough Variant Asthma, and Non-asthmatic Eosinophilic Bronchitis. Lung 2022; 200: 707-716
• 115 Johnstone KJ, Chang AB, Fong KM. et al. Inhaled corticosteroids for subacute and chronic cough in adults. Cochrane Database Syst Rev 2013; 2013: CD009305
• 116 Morice AH, Lowry R, Brown MJ. et al. Angiotensin-converting enzyme and the cough reflex. Lancet 1987; 2: 1116-1118
• 117 Shim JS, Song WJ, Morice AH. Drug-Induced Cough. Physiol Res 2020; 69 (Suppl. 01) S81-S92
• 118 Ding H, Shi C, Xu X. et al. Drug-induced chronic cough and the possible mechanism of action. Ann Palliat Med 2020; 9: 3562-3570
• 119 Holzinger F, Beck S, Dini L. et al. The diagnosis and treatment of acute cough in adults. Dtsch Arztebl Int 2014; 111: 356-363
• 120 Domingo C, Gonzálvez J, Dávila I. et al. Basic assessment of chronic cough in primary care and referral pathways of patients to different specialists. Therapeutic Advances in Respiratory Disease 2023; 17: 17534666231178694
• 121 Bao W, Zhang X, Lv C. et al. The Value of Fractional Exhaled Nitric Oxide and Forced Mid-Expiratory Flow as Predictive Markers of Bronchial Hyperresponsiveness in Adults with Chronic Cough. The Journal of Allergy and Clinical Immunology: In Practice 2018; 6: 1313-1320
• 122 Côté A, Russell RJ, Boulet L-P. et al. Managing Chronic Cough due to Asthma and NAEB in Adults and Adolescents: CHEST Expert Panel Report. Chest 2020; 158: 68-96
• 123 Cheng SL. Blood eosinophils and inhaled corticosteroids in patients with COPD: systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis 2018; 13: 2775-2784
• 124 Lee J-H, Kang S-Y, Yu I. et al. Cough Response to High-Dose Inhaled Corticosteroids in Patients with Chronic Cough and Fractional Exhaled Nitric Oxide Levels ≥ 25 ppb: A Prospective Study. Lung 2024; 202: 275-280
• 125 Burg G, Hossain MM, Wood R. et al. Evaluation of Agreement on Presence and Severity of Tracheobronchomalacia by Dynamic Flexible Bronchoscopy. Annals of the American Thoracic Society 2021; 18: 1749-1752
• 126 Boucher RC. Muco-Obstructive Lung Diseases. New England Journal of Medicine 2019; 380: 1941-1953
• 127 Burnham P, Stanford G, Stewart R. Autogenic drainage for airway clearance in cystic fibrosis. Cochrane Database Syst Rev 2021; 12: CD009595
• 128 Polverino E, Goeminne PC, McDonnell MJ. et al. European Respiratory Society guidelines for the management of adult bronchiectasis. Eur Respir J 2017; 50: 1700629
• 129 Geiseler J, Karg O. Sekretmanagement bei neuromuskulären Erkrankungen. Pneumologie 2008  62 (Suppl. 01)  S43-S48
• 130 Peng Y, Zhang T, Yuan L. et al. Management of non-pharmacologic therapy for chronic refractory cough: Mechanism, composition, applicable population, and assessment. Heliyon 2023; 9: e20351
• 131 Schneeberger T, Weise S, Kenn K. et al. Physiotherapie bei chronischem Husten – Schritt fur Schritt. Pneumologie 2021; 75: 226-234
• 132 Patel AS, Watkin G, Willig B. et al. Improvement in health status following cough-suppression physiotherapy for patients with chronic cough. Chron Respir Dis 2011; 8: 253-258
• 133 Chamberlain S, Birring SS, Garrod R. Nonpharmacological interventions for refractory chronic cough patients: systematic review. Lung 2014; 192: 75-85
• 134 Vertigan AE, Theodoros DG, Gibson PG. et al. Efficacy of speech pathology management for chronic cough: a randomised, single blind, placebo controlled trial of treatment efficacy. Thorax 2006; 61: 1065-1069
• 135 Gibson PG, Vertigan AE. Speech pathology for chronic cough: a new approach. Pulm Pharmacol Ther 2009; 22: 159-162
• 136 Vertigan AE, Haines J, Slovarp L. An Update on Speech Pathology Management of Chronic Refractory Cough. The Journal of Allergy and Clinical Immunology: In Practice 2019; 7: 1756-1761
• 137 Vertigan A, Bone S, Gibson P. Development and validation of the Newcastle laryngeal hypersensitivity questionnaire. Cough 2014; 10: 1
• 138 Edwards DA, Chung KF. Mouth breathing, dry air, and low water permeation promote inflammation, and activate neural pathways, by osmotic stresses acting on airway lining mucus. QRB Discov 2023; 4: e3
• 139 Ryan NM, Vertigan AE, Birring SS. An update and systematic review on drug therapies for the treatment of refractory chronic cough. Expert opinion on pharmacotherapy 2018; 19: 687-711
• 140 Morice AH, Menon MS, Mulrennan SA. et al. Opiate Therapy in Chronic Cough. American Journal of Respiratory and Critical Care Medicine 2007; 175: 312-315
• 141 Abozid H, Baxter CA, Hartl S. et al. Distribution of chronic cough phenotypes in the general population: A cross-sectional analysis of the LEAD cohort in Austria. Respir Med 2022; 192: 106726
• 142 Maher TM, Avram C, Bortey E. et al. Nalbuphine Tablets for Cough in Patients with Idiopathic Pulmonary Fibrosis. NEJM Evid 2023; 2: EVIDoa2300083
• 143 Wu Z, Spencer LG, Banya W. et al. Morphine for treatment of cough in idiopathic pulmonary fibrosis (PACIFY COUGH): a prospective, multicentre, randomised, double-blind, placebo-controlled, two-way crossover trial. The Lancet Respiratory Medicine 2024; 12: 273-280