Two-year follow up of the management of chronic or recurrent cough in children according to an asthma protocol.

To test the hypothesis that many children with a chronic or recurring cough have asthma, 106 children with cough were treated according to an asthma protocol. At the end of 16 weeks, all but two of the children who completed this phase of the trial were free of cough. At a two-year follow up 97 children were reviewed: 71 were now diagnosed as having an asthmatic condition, 34 of whom required regular medication. The original histories of those who developed asthma were compared with those who had no further respiratory symptoms. The results suggest that many children with a chronic or recurring cough have a mild form of asthma, known as cough variant asthma, which is responsive to asthma therapy. Many will subsequently develop mild to moderately severe asthma. Those who subsequently develop an asthmatic condition are statistically more likely to have a family history of asthma or a personal history of atopy. The children are also more likely to have exercise-induced cough or nocturnal exacerbation of their cough. Managing a persistent or recurring cough according to an asthma protocol could mean that many asthmatic children will be diagnosed and treated earlier in the natural history of their illness.