Suggest treatment for severe cough

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Posted on Mon, 24 Nov 2014 in Lung and Chest disorders
Question: Hi,

My mother age 60 years had cough for about two weeks for which our doctor started with course of tab AZID(azithromycin 250 mg * b.i.d * 3 days) followed by tab ALTACEF (cefuroxime axetil 500 mg * b.i.d * 5 days). But when cough did not seems to go away by any of the antibiotics he suggested to stop antibiotics (as per him antibiotics should not be taken too long) and only continue with cough syrup Ascoril (Dextromethorphan). Her chest X ray and blood counts are normal but still cough is not getting cured. Her cough is of type wet cough with white mucus.
We are now using suction machine for last two days for which she gets temporary relief but cough gets back after she wakes up from sleep or after few hours of suction.

Can you please let me know what might be the cause of the issue and suggest possible further treatment?
doctor
Answered by Dr. Praveen 7 hours later
Brief Answer:
Rule out Tb, Prefer Ascoril Expectorant

Detailed Answer:
Hi dear.Welcome and thanks for giving me an opportunity to address your query.

I have gone through the reports and I appreciate your interest for sharing the same.

According to ESR is high and the cough is not responding to antibiotics I were to rule out Tuberculosis by doing sputum AFB, and tuberculin skin test inspite of chest X-ray being normal.This is important since the cough is more than 2 weeks.

I would be glad to know if she is being prescribed Ascoril or Ascoril D?I would recommend only Ascoril Expectorant since Ascoril D is used for dry cough not productive cough.

Hope this answers your query.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen 3 hours later
Hi,

Thanks for the consultation.

I am puzzled over one thing in your reply, that if we 'rule out' (which means 'not to consider' or 'eliminate the chances of') Tuberculosis do we still need to do sputum AFB and tuberculin skin test. Can you please elaborate the term 'Rule out' means?

Also I forgot to mention in my health query that she had little bit fever (100 deg Celsius) three days ago which eventually went away in one and half day.
doctor
Answered by Dr. Praveen 9 hours later
Brief Answer:
Eliminate Tb

Detailed Answer:
Hi dear.Extremely sorry for the medical jargon which might have confused you.

It means that I am only trying to eliminate tuberculosis by doing both the tests which I have previously mentioned.

Evening rise of temperature is seen in Tuberculosis but not necessarily in all.

Please reach me for further clarification you may have.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen 2 days later
Hi,

Thanks once again for the consultation.
Yes we were initially using Ascoril D and now changed it to Ascoril Expectorant.
This was really good point that you identified.
Her cough is much better now and in a day she coughs rarely. But even now whenever she coughs, it seems from coughing sound that there is still some cough in chest. We are using Ascoril Expectorant dosage of 5ml * 4 times/ day.

Can you please let us know what dosage we should follow and for how many days?
Also please suggest if you know any other such good medication like or in case better than Ascoril Expectorant.
doctor
Answered by Dr. Praveen 11 hours later
Brief Answer:
Recommend Bromhexine if necessary

Detailed Answer:
Hi dear.Thanks for writing me back.

Ascoril Expectorant (5ml) has to be taken 3-4 times per day.Watch for the sputum colour.Can be continued up to one week.It is symptomatic treatment.If it is white it indicates the absence of infection.Watch for the quantity if it is reducing day by day then lungs are being cleared of the mucus.

In case the quantity is increasing or colour is yellow/brownish this need immediate attention & further evaluation.

If she has difficulty in coughing out the sputum then I were to recommend Tab.Bromhexine 8mg thrice daily for 5 days along with Ascoril.This helps in thinning the mucus so that it can be easily coughed out.

Advice good hydration(3-4 litres of oral fluids).

Hope this answers your query.Wishing her a healthy and sooner recovery.
Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Praveen

General & Family Physician

Practicing since :2008

Answered : 1055 Questions

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