A cough that will not go away – when to get checked
A cough lasting two weeks or more should be checked for TB in South Africa. What causes a lingering cough, what helps, and the signs that need urgent care.
Two weeks is the number to remember
Most coughs come with a cold or flu and settle within a week or two. A cough that is still there after two weeks is different: South African guidance treats it as a reason to be screened for tuberculosis, whatever else may also be going on. TB screening at a public clinic is free, and you do not need a referral to ask for it.
Other symptoms that raise the concern further are night sweats that soak the bedding, losing weight without trying, a fever that keeps returning, and unusual tiredness. If someone you live with has been treated for TB, say so at the clinic.
The other common reasons a cough lingers
- The tail end of a viral infection. The airways stay irritated for weeks after the infection itself has gone, and the cough slowly fades.
- Asthma, which can show up as a dry cough at night or after exercise rather than as wheezing.
- Post-nasal drip from hay fever or sinus trouble, where mucus running down the back of the throat keeps triggering the cough.
- Reflux, where stomach acid irritates the throat, often worse when lying down.
- Smoking, or regular exposure to smoke, dust or fumes at work or at home.
- A side effect of some blood-pressure medicines, which can cause a persistent dry cough weeks or months after starting.
What actually helps at home
- Fluids and rest. A dry throat coughs more.
- Stopping smoking, and keeping away from indoor smoke. This does more for a lingering cough than any syrup.
- Treating the cause rather than the cough — allergy treatment for post-nasal drip, an inhaler for asthma, reflux measures for reflux.
- Honey in warm water for an irritated throat in adults and children over one year. Never give honey to a baby under one.
Cough mixtures are widely sold and widely oversold. Some loosen thick mucus, such as acetylcysteine; others suppress the cough reflex. Neither treats what is causing the cough, and a pharmacist is the right person to ask whether one is worth using at all in your case.
Medicines a clinician might use, depending on what is actually causing the cough:
Acetylcysteine — ACC, Solmucol, Fluimucil, Mucomyst
Productive cough (mucolytic); paracetamol overdose (IV — antidote)
Salbutamol (Inhaler) — Ventolin, Asthavent, Cipla Salbutamol, Aerolin
Asthma (reliever); COPD (reliever); acute bronchospasm
Amoxicillin — Amoxil, Betamox, Moxypen, Ospamox
Upper and lower respiratory tract infections; UTIs; skin infections; otitis media; H. pylori eradication
When a cough is an emergency
Common questions
- How long is too long for a cough?
- Two weeks. In South Africa a cough lasting two weeks or more is a reason to be screened for TB, free of charge at a public clinic, regardless of what else you think is causing it.
- Do I need antibiotics for a cough?
- Usually not. Most coughs follow a viral infection, which antibiotics do not treat. They are used when a clinician finds signs of a bacterial infection such as pneumonia.
- Can blood-pressure tablets cause a cough?
- Some can cause a persistent dry cough, sometimes starting weeks or months after you began them. It is a well-recognised side effect and there are alternatives, so tell the clinic what you are taking.
Sources
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Adult Primary Care guide: symptom-based integrated approach to the adult in primary careNational Department of Health, South Africa
- Communicable disease surveillance and clinical guidanceNational Institute for Communicable Diseases, South Africa
- Medicines Online Directory and approved patient information leafletsSouth African Health Products Regulatory Authority
Last reviewed 11 August 2026.