Updated 24 August 2017

Treating an acute cough

Coughs are treated according to the type of cough, the stage of the cough, but most of all according to the underlying cause.


Treatment depends entirely on the cause of the acute cough. More than likely the cause is an acute upper respiratory infection caused by one of the common ‘cold’ viruses and this cough will resolve without any treatment whatsoever. There are hundreds of over the counter preparations advertised to help with cough though very few, if any, have actually been proven to work. 

The age-old suggestion of bed rest, taking it easy, drinking plenty of fluids and letting mother nature do the healing is certainly the best advice. As your body wards off the virus so the cough will settle without any need for treatment.  All the cough suppressants merely provide simple symptomatic relief and do not alter the natural course of the flu at all. 

Some of the agents used to help suppress a cough include:

Dextromethorphan – centrally acting opiate (like morphine), which is non-sedating. There is a single study showing some mild benefit though the dose used if often sub-therapeutic to suppress a cough. Dextromethorphan needs to be used with caution as often combined with other agents which then may be taken in toxic doses to get the desired effects of the dextromethorphan.

Menthol – has been well described to suppress the cough reflex though its effect is often very short-lived thus not that useful.

Antihistamines – are often combined in cough preparations to suppress a cough though unfortunately are often sedating

Codeine – again often used in combination cough suppressants. Unfortunately the dose used is often way below the required therapeutic dose hence the codeine is not effective

Compiled February 2011 by Dr. Greg Symons [MB. ChB, DipPEC, FCP (SA), Cert. Pulm. (SA)], Consultant Pulmonologist, Division of Pulmonology, Department of Medicine, Groote Schuur Hospital & Clinical Researcher, UCT Lung Institute (Pty) Ltd in George Street, Mowbray. Contact the UCT Lung Institute on ph 021-406-6850.


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Professor Keertan Dheda has received several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others. Read his full biography at the University of Cape Town Lung Institute.

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