Should we advise parents to administer over the counter cough medicines for acute cough? Systematic review of randomised controlled trials

Schroeder, Knut; Fahey, Tom

doi:10.1136/adc.86.3.170

Cited by 70 publications

(53 citation statements)

References 9 publications

(8 reference statements)

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“…Several reviews, including the American Academy of Pediatrics guidelines, note that there have been no well-controlled studies that support the efficacy of DM in children; it is the most common antitussive ingredient in OTC cough products (4,10,11). Furthermore, there have been similar results from these reviews for the other active ingredients of most OTC preparations (10,11). Recent original trials (8,14,15) have further supported this claim, finding, respectively, that antihistamine-decongestant combinations, DM and diphenhydramine show no increase in efficacy over placebo on any of the outcome measures studied.…”

Section: Ssri Selective Serotonin Reuptake Inhibitorssupporting

confidence: 57%

“…Numerous evidencebased reports, including several systematic reviews of the literature in this area (5)(6)(7)(8)(9)(10)(11), have stated otherwise. In fact, each of the classes of drugs included in these formulations has its own list of associated adverse effects (Table 1) and they often coincide, increasing the danger inherent in combination medications that include many of these preparations (5,6).…”

mentioning

confidence: 99%

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What is the evidence for the safety and efficacy of over-the-counter cough and cold preparations for children younger than six years of age?

Dolansky

Rieder

2008

Paediatrics &Amp; Child Health

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Section: Ssri Selective Serotonin Reuptake Inhibitorssupporting

confidence: 57%

mentioning

confidence: 99%

What is the evidence for the safety and efficacy of over-the-counter cough and cold preparations for children younger than six years of age?

Dolansky

Rieder

2008

Paediatrics &Amp; Child Health

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“…[8][9][10][11][12][13] Objective assessments of DM in adults with URI also have had conflicting results. [14][15][16] DPH is generally thought to be ineffective when compared with PL for the treatment of acute cough as a result of URIs, [17][18][19] but some reports contradict this belief.…”

mentioning

confidence: 99%

Effect of Dextromethorphan, Diphenhydramine, and Placebo on Nocturnal Cough and Sleep Quality for Coughing Children and Their Parents

Paul¹,

Yoder

Crowell³

et al. 2004

Pediatrics

151

105

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ABSTRACT. Objectives. To determine whether the commonly used over-the-counter medications dextromethorphan and diphenhydramine are superior to placebo for the treatment of nocturnal cough and sleep difficulty associated with upper respiratory infections and to determine whether parents have improved sleep quality when their children receive the medications when compared with placebo.Methods. Parents of 100 children with upper respiratory infections were questioned to assess the frequency, severity, and bothersome nature of the nocturnal cough. Their answers were recorded on 2 consecutive days, initially on the day of presentation, when no medication had been given the previous evening, and then again on the subsequent day, when either medication or placebo was given before bedtime. Sleep quality for both the child and the parent were also assessed for both nights.Results. For the entire cohort, all outcomes were significantly improved on the second night of the study when either medication or placebo was given. However, neither diphenhydramine nor dextromethorphan produced a superior benefit when compared with placebo for any of the outcomes studied. Insomnia was reported more frequently in those who were given dextromethorphan, and drowsiness was reported more commonly in those who were given diphenhydramine.Conclusions. Diphenhydramine and dextromethorphan are not superior to placebo in providing nocturnal symptom relief for children with cough and sleep difficulty as a result of an upper respiratory infection. Furthermore, the medications given to children do not result in improved quality of sleep for their parents when compared with placebo. Each clinician should consider these findings, the potential for adverse effects, and the individual and cumulative costs of the drugs before recommending them to families. Pediatrics 2004;114:e85-e90. URL: http://www.pediatrics.org/cgi/content/full/114/ 1/e85; cough, upper respiratory infection, dextromethorphan, diphenhydramine, placebo.

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“…This is not the case, however, if the 2 most commonly used classes of OTC medications (those for coughs and colds and antipyretics) are examined. A series of systematic reviews have found that OTC cough mixtures are no more useful than placebo, [12][13][14][15] and the use of antipyretics in controlling fevers is of dubious value. 16 In fact, it appears that both doctors and parents have unrealistic expectations regarding the natural history of childhood coughs and colds, 17 and this is fertile ground for the advertising and sale of (inefficacious) OTC medications.…”

mentioning

confidence: 99%

“Social Medication” and the Control of Children: A Qualitative Study of Over-the-Counter Medication Among Australian Children

2004

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ABSTRACT. Objective. The aim of the study was to identify the patterns of use of over-the-counter (OTC) medications among children.Methods. The study used a qualitative design, with in-depth interviews of 40 parents with children <5 years of age.Results. There were 3 striking and readily apparent themes in the use of OTC medications among children. One was the administration of OTC medications as a form of "social medication," to give parents control over children's behavior that they perceived as fractious and irritating. A related theme was the use of OTC medications to reduce the inconvenience to the parents of having a sick child, again giving parents greater control and better time-management abilities. Finally, acetaminophen was considered by many parents to have almost miraculous properties in calming, sedating, and lifting the mood of children.Conclusions. The use of OTC medications for the treatment of minor ailments among children is widespread, despite the lack of evidence of efficacy of the most commonly used medications and the potential for toxicity. With the increasing propensity to look to medication as a means of supporting changing lifestyles, there is an urgent need to review the prevalence and effects of social medication. Pediatrics 2004; 114:e378 -e383. URL: http://www.pediatrics.org/cgi/ content/full/114/3/e378; parental stress, parental perception, child behavior, drug safety, over-the-counter. ABBREVIATION. OTC, over-the-counter T he late 19th century saw a rising culture of self-medication and ready-to-use drugs for infants, many of which were opiates. In Australia, for instance, proprietary medicines became a common feature in the home and were administered to children almost as soon as they became restless or "cross" in the night. 1 Syrups, "soothers," and teething powders were used for common, minor, health concerns such as "wind" and coughs. To pacify children, chemists, confectioners, and door-to-door salesmen sold narcotic lozenges, prepared with morphine and opium. 1 Teething, which was considered a major health problem for infants and was described as a period filled with "terror to a mother's imagination," was often recorded as the actual cause of death of a child, although now it is thought that the deaths were probably caused by the teething powders themselves, which were made of chloride of mercury and opium. 2 Although these products were marketed as "perfectly mild and free from danger," a coronial inquiry into a spate of infant deaths around 1880 found that many of these medications recommended unsafe doses of alcohol, morphine, and other opiates. An Australian Royal Commission in 1907 reported that 15 000 children were killed every year by soothing syrups and similar preparations. 3 Medications in various (more benign) forms have, however, remained an important feature in the management of many minor "ailments" among children. Over-the-counter (OTC) medications, for example, are promoted through television, radio, and print advertising. The advertisements, which are prim...

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Should we advise parents to administer over the counter cough medicines for acute cough? Systematic review of randomised controlled trials

Cited by 70 publications

References 9 publications

What is the evidence for the safety and efficacy of over-the-counter cough and cold preparations for children younger than six years of age?

What is the evidence for the safety and efficacy of over-the-counter cough and cold preparations for children younger than six years of age?

Effect of Dextromethorphan, Diphenhydramine, and Placebo on Nocturnal Cough and Sleep Quality for Coughing Children and Their Parents

“Social Medication” and the Control of Children: A Qualitative Study of Over-the-Counter Medication Among Australian Children

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