Second, while it is helpful to know that subacute cough may resolve spontaneously, it does not follow that treatment with an antihistamine-decongestant should be withheld. Patients with cough are seeking help for a bothersome symptom. Because it is not possible to predict in which patients subacute cough will spontaneously resolve or how long it might take, it does not make sense to withhold treatment. The patient is suffering from the cough. The “up-front” use of an antihistamine-decongestant frequently abbreviates the cough with minimal side effects.4–5 Therefore, the decision not to treat because cough might resolve over time is not an optimal approach. We recommend that a first-generation antihistamine-decongestant (our choice is sustained release brompheniramine, 12 mg, and pseudoephedrine, 120 mg every 12 h) be administered as the initial therapy whatever the duration of cough, unless there is a contraindication to one of these drugs. This empiric approach makes sense because postnasal drip syndromes appear to be the most common causes of cough; this approach has been shown to work in patients with acute cough,4 subacute cough,3 and chronic cough.2,5 If 2 weeks of therapy is ineffective, we would proceed with a BPC. Many of these patients will have either cough-variant asthma or virus-induced transient airway hyperresponsiveness. As the results of the study by Kwon et al3 show, a positive BPC result is predictive of a positive response to therapy with inhaled corticosteroids. If BPC is unavailable, then an empiric course of inhaled corticosteroids is reasonable because it will treat cough-variant asthma, transient virus-induced airway hyperresponsiveness, and eosinophilic bronchitis.