Ordinarily, an acute cough is self-limiting to three to four weeks. It is most commonly caused by a viral infection of the upper respiratory tract such as a cold or flu.12

Acute bronchitis, a lower respiratory tract infection which is usually viral but can be bacterial, can also cause a cough, especially in children under 5 years. The infection causes temporary inflammation (usually no more than three weeks) in the trachea and major bronchi with increased mucus production.12,15

Other infective and non-infective causes are also possible. Smoking, acid reflux, allergies, and a post-nasal drip are all common causes of coughs.12,16

Promoting self-care has a role in reducing antibiotic prescriptions and general practice consultations. The NICE/PHE advice for an acute cough starts with self-care recommendations. Although there is “limited evidence for the relief of cough symptoms” the advice is:9,17,18

·       for anyone over 12 months: honey

·       for anyone aged 12 years or over: herbal mixture containing pelargonium, expectorants containing guaifenesin, or cough suppressants (eg dextromethorphan but not codeine).

No antibiotics should be prescribed for an acute cough with a URTI, and an antibiotic should not be routinely prescribed for acute bronchitis. Patients should not be offered a bronchodilator such as salbutamol, an oral or inhaled corticosteroid, or a mucolytic such as acetylcysteine or carbocisteine for acute cough associated with a URTI or acute bronchitis.9,12