An observational study on cough in children: epidemiology, impact on quality of sleep and treatment outcome

Abstract

BackgroundCough is one of the most frequent symptoms in children and is the most common symptom for which children visit a health care provider.MethodsThis is an observational study on acute cough associated with upper respiratory tract infection (URTI) in children. The study evaluates the epidemiology and impact of cough on quality of sleep and children's activities, and the outcome of cough with antitussive treatments in pediatric routine clinical practice. Study assessments were performed through a pediatric cough questionnaire (PCQ), developed by the Italian Society of Cough Study. A total of 433 children visited by family care pediatricians for acute cough due to a URTI were enrolled in this study, with mean age of 6.1 years (SD 3.6). Cough type, duration, severity and frequency, cough impact on sleep disturbances of children and parents and on school and sport activities were assessed at baseline. In a subset of 241 children who were either treated with antitussive drugs (levodropropizine n = 101, central antitussives n = 60) or received no treatment (n = 80), the outcome of cough after 6 days was analyzed in terms of resolution, improvement, no change, or worsening. Descriptive analysis, χ2 test, and multivariate analysis with stepwise logistic regression were performed.ResultsCough disturbed sleep in 88% of children and 72% of parents. In children treated with cough suppressants, the duration, type, intensity, and frequency cough were similar at baseline in the two groups respectively treated with levodropropizine and central antitussives (cloperastine and codeine). Both levodropropizine and central drugs reduced cough intensity and frequency. However, percentage of cough resolution was higher with levodropropizine than with central antitussives (47% vs. 28% respectively, p = 0.0012).ConclusionsAcute cough disturbs sleep in most children and their parents. Both levodropropizine and central antitussives reduced cough intensity, with levodropropizine producing a higher cough resolution rate.

Antitussive Drugs—Past, Present, and Future

“…De Blasio et al (2012) performed an observational study on pediatricians' routine clinical practice, including all children who presented to the offices of four family care pediatricians with acute cough (i.e., onset #3 weeks) associated with URTI. Of the 433 patients investigated having a mean age of 6.1 years, 80 received no treatment of cough, 101 children received levodropropizine, and 60 patients were treated with a centrally acting antitussive (51 with cloperastine and 9 with codeine).…”

The difficult coughing child: prolonged acute cough in children

“…In one study parents assessed the cough as moderate or severe in more than 80% cases and the coughing to be frequent or continuous in more than 70% cases [3]. The longest cough duration in this study was 21 days and initially more than 50% of parents described the cough as dry with the remainder reporting the cough to be productive or of a mixed type.…”

Codeine should not be prescribed for breastfeeding mothers or children under the age of 12

“…Both levodropropizine and the two central drugs reduced cough intensity and frequency. However, the percentage of cough resolution was higher with levodropropizine (47%) than with central antitussives (28%) .…”