Differential diagnosis of cough in children and syndrome-based therapeutic approaches. A review

Cough is the primary clinical symptom of respiratory diseases in children and represents the most common reason for seeking medical care in pediatric practice. Although acute respiratory infections are predominantly benign, cough may persist or become chronic, necessitating a comprehensive diagnostic evaluation and a syndrome-based therapeutic approach. This article reviews current concepts regarding the pathophysiological mechanisms of cough in children, including the role of mucociliary clearance disorders and alterations in the rheological properties of bronchial secretions. Clinical variants of cough are discussed considering their duration and productivity, along with key aspects of differential diagnosis in acute, subacute, and chronic presentations. Emphasis is placed on rational therapeutic principles aimed at restoring bronchial drainage, reducing inflammation, and minimizing unnecessary antibiotic use. The article also examines the use of standardized herbal medicines with established clinical efficacy and favorable safety profiles in pediatric practice. Experimental and clinical evidence indicate that combined extracts of thyme and ivy exhibit multicomponent mechanisms of action, including mucolytic, bronchodilator, anti-inflammatory, and antimicrobial effects. Their favorable safety profiles support considering these herbal medicinal products as promising components in the comprehensive management of cough and respiratory tract inflammatory diseases.