Last winter and early spring (before COVID-19), my office received many calls from patients complaining about a cough that just wouldn’t go away. There was an upper respiratory virus going around that caused people to feel sick for weeks. Many asked for more antibiotics, which wouldn’t have helped. Eventually it subsided. Sometimes, however, a cough may last for many months, even years. The term for this is refractory chronic cough (RCC). Today I would like to discuss the causes, work-up, and treatment of RCC.
The most common causes of RCC are the use of an angiotensin-converting enzyme inhibitor, or ACE inhibitor (i.e. lisinopril), which is used to treat high blood pressure, asthma, chronic obstructive pulmonary disease (COPD, aka