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

Abstract

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.

Clinical Efficacy and Safety of Liquid Pelargonium sidoides Preparation (EPs 7630) in Children with Acute Non-Streptococcal Tonsillopharyngitis

“…Children with non-streptococcal tonsillopharyngitis are often over-treated with antibiotics (32). As shown in this study, 6-day administration of EP 7630 in pediatric patients with acute non-streptococcal tonsillopharyngitis resulted in improvement that was significantly superior to placebo as confirmed by a clinically relevant decrease of disease symptoms.…”

Clinical Efficacy of Novel Filmogen, Antimicrobial, Cleaning, Fluidizing Cough Treatment

“…Almost all systemic drugs induce side effects and cause more harm than good, whereas topically applying any chemical on the LRT would block the healing of damaged URT mucosa [28]. Taking into consideration the future research on mono-target anticough drugs, multiple side effects [29,30], development of bacterial resistance and inefficacy of antibiotics for the treatment of dry cough [31,32], F-VB-Gy opens a totally new horizon not only for the treatment of dry or wet cough, but potentially also for the treatment of other topical diseases having a multifactorial origin [33][34][35]. Further research is required to use this non-invasive technology for the treatment of other topical diseases for which there is still no effective treatment available.…”

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

“…Zanasi et al conducted a prospective observational study in 330 children and adolescents to compare levodropropizine, antibiotics, the combination of both, or no treatment, to treat acute cough caused by URTI 23 and found that levodropropizine was more effective than antibiotics in reducing cough. Currently, levodropropizine is indicated for short-term symptomatic treatment of acute cough both in children older than 2 years and adults.…”