Non-adherence of primary care pediatricians in Serbia to the latest guidelines for the management of acute and chronic cough in children

Introduction: Cough is the most frequent symptom in children and can indicate various pathological conditions. Several international guidelines have been published with a purpose of standardizing and improving the assessment and management of cough. Non-adherence to guidelines often leads to a suboptimal quality of patient care. Our aim was to investigate the adherence of Serbian primary care pediatricians to the latest international guidelines on cough diagnosis and management. Methods: The study included pediatricians working in primary health care centers in Serbia. They were given a questionnaire designed by a team of pediatric pulmonologists which included questions about the choice of diagnostic and therapeutic approaches in acute and chronic cough. Results: Most of primary care pediatricians assessed the value of international guidelines as fair. However, nearly 70% stated that they prescribed herbal syrup for acute cough. Chronic cough is treated mostly with ivy extract, bronchodilators and antihistamines. A majority of doctors declared positive opinion of herbal medicaments and negative opinion of alternative medicine. About 73% stated that they did not use the chest x-ray as a part of diagnostic procedure. Conclusion: Serbian pediatricians do not adhere to international guidelines in relation to diagnosis and treatment of cough. The reasons for non-adherence to guidelines should be further investigated.