Efficacy of levodropropizine in pediatric cough

Blasio, Francesco De; Dicpinigaitis, Peter V.; Danieli, G; Lanata, Luigi; Zanasi, Alessandro

doi:10.1016/j.pupt.2012.05.010

Cited by 14 publications

(6 citation statements)

References 15 publications

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“…the present study, levodropropizine appeared to be the most effective option at relieving cough. In light of previously demonstrated efficacy data [ 12 , 18 , 19 ] and the considerable safety profile of levodropropizine [ 18 , 20 ], these results further support its use for the management of acute pediatric cough associated with URTI. Further large randomized clinical trial in children should be conducted in order to confirm the effectiveness of antitussive drugs used in this observational study.…”

Section: Discussionsupporting

confidence: 66%

Prospective study of the efficacy of antibiotics versus antitussive drugs for the management of URTI-related acute cough in children

Zanasi

Lanata

Saibene

et al. 2016

Multidiscip Respir Med

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BackgroundAcute cough is one of the most frequent symptoms prompting a visit to a health care provider, usually following a viral upper respiratory tract infection (URTI). The disproportionate use of antibiotics in children with URTIs, recently highlighted in the medical literature, could lead to associated side effects, without any beneficial effect. Although an early, albeit inappropriate, antibiotic prescription increases parental satisfaction, URTIs are predominantly viral infections and are generally self-limiting. Therefore the aim of this study was to analyze the effectiveness of antibiotics compared to symptomatic drugs (central and peripheral antitussives) on URTI-related cough in a pediatric population.MethodsThis is a prospective observational study of 330 children who required pediatric consultation for acute cough. Severity, frequency and type of cough were assessed at baseline and after 6 days of treatment (antitussives n = 123, antibiotics n = 89 or combination of them n = 38) or no treatment (n = 80). The outcome of cough management after 6 days was analyzed in terms of resolution, improvement, no change or worsening of symptoms. Study assessments were performed using a standardized questionnaire administered to parents.ResultsBetween children treated with antitussives or antibiotics, there was a statistically significant difference in the resolution of cough. Moreover, if considering peripheral antitussives, the resolution of cough was significantly higher with antitussives than with antibiotics (p < 0.01). There was no difference in cough resolution between children treated with antitussives and those receiving a combination of antibiotics and antitussives, either central and peripheral antitussives.ConclusionAntibiotics are generally not useful nor appropriate in treating acute cough due to the common cold. Furthermore, inappropriate antibiotic use introduces the possibility of adverse side effects as well as promotion of antibiotic resistance. The findings of the present study suggest that antitussives, especially peripherally acting agents, represent an effective treatment option for acute pediatric cough caused by URTIs.

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Section: Discussionsupporting

confidence: 66%

Prospective study of the efficacy of antibiotics versus antitussive drugs for the management of URTI-related acute cough in children

Zanasi

Lanata

Saibene

et al. 2016

Multidiscip Respir Med

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“…However, a symptomatic treatment of acute cough with antitussive agents is often needed in order to improve the quality of life, restore physical and social activities, and hopefully avoid the development of persistent cough. 94,98,99 Therapeutic options for the management of acute cough in children are limited because of the lack of data to support the efficacy of currently available antitussives in the pediatric population, as well as unacceptable side effects and safety concerns associated with most agents used in the management of adult cough (90,92), Furthermore, frequently, patients adopt a "do-it-yourself" approach and also resort to OTC medicines, most of which do not show a clinically proven efficacy and reliability in supporting their use. Among the drugs currently used for the symptomatic treatment of cough, peripherally acting antitussives such as levodropropizine should be recommended especially in children for the favorable risk-benefit ratio.…”

Section: Discussionmentioning

confidence: 99%

“…Among the drugs currently used for the symptomatic treatment of cough, peripherally acting antitussives such as levodropropizine should be recommended especially in children for the favorable risk-benefit ratio. 24,92,94 Despite the knowledge of cough reflex and factors that lead to a hypertussive status having significantly advanced in recent years, these findings have not yet been translated into clinical practice as well as in approved new medicines. The number of studies in each category of cough medications is very small, and availability, dosing, and treatment duration of OTC drugs vary significantly among studies.…”

Section: Discussionmentioning

confidence: 99%

“…Despite a number of evidence-based guidelines and systematic reviews published more than a decade ago, which do not recommend pharmacological treatment of acute cough in children, [88][89][90][91] a safe and effective antitussive therapy remains a significant area of unmet need. 92 Most cough suppressants used in adults present an unacceptable risk-benefit profile for pediatric use because of the potential for excessive sedation (narcotics as codeine and hydrocodone), dextromethorphan, and first-generation antihistamine or hyperstimulation (pseudoephedrine and phenylephrine). 89,92,93 Furthermore, although nonpharmacological, supportive care with analgesics, hot beverages, lozenges and honey are commonly used by many pediatricians, unfortunately these strategies are often ineffective (90).…”

Section: Transient Receptor Potential Receptorsmentioning

confidence: 99%

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Acute cough in children and adolescents: A systematic review and a practical algorithm by the Italian Society of Pediatric Allergy and Immunology

Marseglia

Manti

Chiappini

et al. 2021

aei

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The current systematic review presented and discussed the most recent studies on acute cough in pediatric age. After that, the Italian Society of Pediatric Allergy and Immunology elaborated a comprehensive algorithm to guide the primary care approach to pediatric patients, such as infants, children, and adolescents, with acute cough. An acute cough is usually consequent to upper respiratory tract infections and is self-resolving within a few weeks. However, an acute cough may be bothersome, and therefore remedies are requested, mainly by the parents. An acute cough may significantly affect the quality of life of patients and their family.Several algorithms for the management of acute cough have been adopted and validated in clinical practice; however, unlike the latter, we developed an algorithm focused on pediatric age, and, also, in accordance to the Italian National Health System, which regularly follows the child from birth to all lifelong. Based on our findings, infants from 6 months, children, and adolescents with acute cough without cough pointers can be safely managed using well-known medications, preferably non-sedative agents, such as levodropropizine and/or natural compounds, including honey, glycerol, and herb-derived components.

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“…The study of De Blasio et al [10] was an observational one, carried out in 433 children (mean age 6 years) whose aim was to evaluate the efficacy of antitussive drugs in reducing the severity of acute cough associated with a URTI. A subgroup of 161 children received antitussive treatment with levodropropizine (N = 101) or central cough suppressants (codeine or cloperastine, N = 60).…”

Section: Methodsmentioning

confidence: 99%

Levodropropizine for treating cough in adult and children: a meta-analysis of published studies

Zanasi

Lanata

Fontana

et al. 2015

Multidiscip Respir Med

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BackgroundCough is one of the most common symptoms for which patients seek medical attention from primary care physicians and lung specialists. About 40% of the population at any one time report cough.Cough is associated with significantly impaired health-related quality of life.Levodropropizine is an effective and very well tolerated peripheral antitussive drug. We want to compare it to central cough suppressants efficacy (opioids and non-opioids) that may be associated with side effects limiting their use.MethodsAfter a comprehensive literature search, a meta-analysis of 7 clinical studies of levodropropizine vs. control, including a total of 1,178 patients, was performed with the aim to evaluate the overall comparative efficacy of levodropropizine in the pediatric and adult population.Three electronic databases and reference list were used to search for studies that assessed the efficacy of levodropropizine for treating cough in children and adults using as standardized efficacy parameters the cough frequency and severity, and number of night awakenings as outcome parameters.ResultsThe meta-analysis of all standardized efficacy parameters showed a highly statistically significant difference in the overall antitussive efficacy in favor of levodropropizine vs. control treatments (p = 0.0015).The heterogeneity test for the efficacy outcome was not statistically significant (p = 0.0534).Seven studies met out inclusion criteria. A meta-analysis of the eligible ones showed a statistically significant difference in the overall anti-tussive effect of levodropropizine versus control (p = 0.0015).ConclusionsThis analysis indicates that levodropropizine is an effective antitussive drug in children and adults, with statistically significant better overall efficacy outcomes vs. central antitussive drugs (codeine, cloperastine, dextromethorphan) in terms of reducing cough intensity and frequency, and nocturnal awakenings. This result further reinforces the favorable benefit/risk profile of levodropropizine in the management of cough. The efficacy of levodropropizine in the treatment of cough in children and adults is higher than that of the common centrally-acting anti-tussive.

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Efficacy of levodropropizine in pediatric cough

Cited by 14 publications

References 15 publications

Prospective study of the efficacy of antibiotics versus antitussive drugs for the management of URTI-related acute cough in children

Prospective study of the efficacy of antibiotics versus antitussive drugs for the management of URTI-related acute cough in children

Acute cough in children and adolescents: A systematic review and a practical algorithm by the Italian Society of Pediatric Allergy and Immunology

Levodropropizine for treating cough in adult and children: a meta-analysis of published studies

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