Postnasal drip and chronic cough: An open interventional study

Respir Med. 2009 Nov;103(11):1700-5. doi: 10.1016/j.rmed.2009.05.005. Epub 2009 May 29.


Background: The postnasal drip (PND) syndrome is often linked as a cause of chronic cough although this is disputed.

Objectives: We examined the effect of specific topical treatment of rhinosinusitis on cough in patients presenting with a chronic cough associated with a postnasal drip or 'nasal catarrh'.

Methods: Patients presenting with a chronic cough and who complained of PND were enrolled and symptoms of PND and cough were assessed by questionnaire and by a capsaicin cough response. Rhinosinusitis was assessed by questionnaires, direct examination of the nose and by high-resolution computed tomography. In an open study, they were treated with fluticasone nasules, ipratropium bromide and azelastine nasal sprays for 28 days, after which they were re-assessed.

Results: Eighteen out of 21 patients completed the study. All patients reported having the presence of mucus in the throat. Mean cough score improved post-treatment (p<0.05), but there was no significant change in capsaicin cough sensitivity or nasal catarrh questionnaire score. There was improvement in anterior nasal discharge symptom scores (p=0.005) and in endoscopic nasal scores post-treatment (p<0.01), with a tendency to improved PND scores.

Conclusion: In a pilot open 'real-life' study treatment targeted towards rhinosinusitis accompanying PND syndrome and chronic cough led to an improvement in cough. A randomised controlled study is now needed to confirm or refute these findings.

MeSH terms

  • Administration, Intranasal
  • Adolescent
  • Adult
  • Aged
  • Androstadienes / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Chronic Disease
  • Cough / diagnostic imaging
  • Cough / drug therapy
  • Cough / etiology*
  • Female
  • Fluticasone
  • Humans
  • Male
  • Middle Aged
  • Nasal Mucosa / metabolism*
  • Phthalazines / administration & dosage
  • Quality of Life
  • Rhinitis / complications*
  • Rhinitis / diagnostic imaging
  • Rhinitis / drug therapy
  • Sinusitis / complications*
  • Sinusitis / diagnostic imaging
  • Sinusitis / drug therapy
  • Surveys and Questionnaires
  • Syndrome
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult


  • Androstadienes
  • Anti-Inflammatory Agents, Non-Steroidal
  • Phthalazines
  • Fluticasone
  • azelastine