Pre-referral guidelines for primary care providers

Cough is extremely common in children, with the most common causes being viral respiratory tract infections and subsequent post-viral cough. A daily cough lasting more than 3 weeks is considered persistent.

For the management of cough, please refer to the Royal Children’s Hospital clinical practice guidelines.

Practice points

  • Cough suppressant medication is not advised in children, nor is there any good evidence of benefit.
  • There is no evidence for the role of antibiotics, decongestants, codeine containing mixtures or antihistamines in the management of cough in otherwise well children with a normal examination.

Referral pathways

  • Paediatrician
    • Referral to paediatric outpatient services is not appropriate in the management of acute cough.
    • Most cases of chronic cough can be adequately managed in the general practice setting. Referral to paediatric outpatient services can be considered in the management of chronic cough when management steps as outlined in the RCH clinical practice guidelines are failing to contain symptoms adequately.
  • Other resources