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Document Overview

Design and created by Guideline Central in participation with the American College of Chest Physicians.

Chronic Cough Related to Acute Viral Bronchiolitis in Children

American College of Chest Physicians

Publication Date: Aug 1, 2018

Page Last Updated: May 5, 2026

ACCP Classification Scheme for Grading Evidence and Recommendations in Clinical Guidelines

ACCP Classification Scheme for Grading Evidence and Recommendations in Clinical Guidelines
Grade	Description	Benefits vs risks and burdens	Methodologic quality of supporting evidence
1A	Strong recommendation, high-quality evidence	Benefits clearly outweigh risks and burdens or vice versa	RCTs without important limitations or overwhelming evidence from observational studies
1B	Strong recommendation, moderate-quality evidence	Benefits clearly outweigh risks and burdens or vice versa	RCTs with important limitations or exceptionally strong evidence from observational studies
1C	Strong recommendation, low-quality or very low quality evidence	Benefits clearly outweigh risks and burdens or vice versa	Observational studies or case series
2A	Weak/Conditional recommendation, high-quality evidence	Benefits closely balanced with risks and burdens	RCTs without important limitations or overwhelming evidence from observational studies
2B	Weak/Conditional recommendation, moderate-quality evidence	Benefits closely balanced with risks and burdens	RCTs with important limitations or exceptionally strong evidence from observational studies
2C	Weak/Conditional recommendation, low-quality or very low quality evidence	Uncertainty in the estimates of benefits, risks, and burdens; benefits, risk, and burden may be closely balanced.	Observational studies or case series
U-CBS	Ungraded consensus-based statement

ACCP: American College of Chest Physicians; RCT: Randomized controlled trial.

Document Overview

Document Title: Chronic Cough Related to Acute Viral Bronchiolitis in Children

Authoring Society: American College of Chest Physicians

Document Publication Date: Aug 1, 2018

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: journal.chestnet.org/article/S0012-3692(18)30632-9/fulltext

Source Citation: DOI: https://doi.org/10.1016/j.chest.2018.04.019

Document Scope, Criteria, and Use Cases

Document Objectives: Acute bronchiolitis is common in young children, and some children develop chronic cough after their bronchiolitis. We thus undertook systematic reviews based on key questions (KQs) using the PICO (Population, Intervention, Comparison, Outcome) format. The KQs were: Among children with chronic cough (> 4 weeks) after acute viral bronchiolitis, how effective are the following interventions in improving the resolution of cough?: (1) Antibiotics. If so what type and for how long? (2) Asthma medications (inhaled steroids, beta₂ agonist, montelukast); and (3) Inhaled osmotic agents like hypertonic saline?

Scope: Assessment and Screening, Management, Treatment

Diseases/Conditions (MeSH)

D001988 - Bronchiolitis

D010372 - Pediatrics

D003371 - Cough

D018927 - Anti-Asthmatic Agents

D001988 - Bronchiolitis

D010372 - Pediatrics

D003371 - Cough

D018927 - Anti-Asthmatic Agents

Keywords: antibiotic, bronchiolitis, chronic cough, cough, pediatric, pediatrics

Target Patient Population: Children with chronic cough after bronchiolitis

Inclusion Criteria: Male, Female, Child

Health Care Settings: Ambulatory, Childcare Center, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents: 84

Includes peer/external review process?: No

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: No