Over-the-counter (OTC) medications to reduce cough as an adjunct to antibiotics for acute pneumonia in children and adults

Chang, Christina C., Cheng, Allen C. and Chang, Anne B. (2012) Over-the-counter (OTC) medications to reduce cough as an adjunct to antibiotics for acute pneumonia in children and adults. Cochrane Database of Systematic Reviews, 2: 1-35. doi:10.1002/14651858.CD006088.pub3

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Author Chang, Christina C.
Cheng, Allen C.
Chang, Anne B.
Title Over-the-counter (OTC) medications to reduce cough as an adjunct to antibiotics for acute pneumonia in children and adults
Journal name Cochrane Database of Systematic Reviews   Check publisher's open access policy
ISSN 1469-493X
Publication date 2012-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1002/14651858.CD006088.pub3
Issue 2
Start page 1
End page 35
Total pages 35
Place of publication Oxford, U.K.
Publisher John Wiley & Sons
Collection year 2013
Language eng
Formatted abstract
Over-the-counter medications to help reduce cough for children and adults on antibiotics for acute pneumonia

There are many causes of acute cough, one of which is pneumonia. Cough is burdensome and impairs quality of life. To ameliorate cough, over-the-counter (OTC) medications are commonly used by patients and recommended by healthcare staff as adjuncts in the treatment of pneumonia. There are many classes of OTCs for cough, such as mucolytics (medications that can reduce the thickness of mucus) and antitussives (medications that suppresses cough).

In this review we found four studies with a total of 224 participants that were suitable for inclusion; one was performed exclusively in children and three in adolescents or adults. However, data could only be obtained from two studies; both studies used mucolytics (ambroxol and bromhexine) in conjunction with antibiotics. Combining these two studies, the rate of cure or improvement in cough of people who received mucolytics was similar to those who did not. However, in the secondary analysis, children who received a mucolytic were more likely to be cured of cough (number needed to treat to benefit (NNTB) at day 10 was 5 (95% CI 3 to 16) for children and 4 (95% CI 3 to 8) for adults). There were no reported increased adverse events in the treatment group.

The range of possible adverse events in OTCs for cough is wide and includes minimal adverse events (such as use of honey) to serious adverse events such as altered heart rate patterns, drowsiness and death in young children. The studies included in this review did not report any detectable increase in adverse events.

The review has substantial limitations due to the unavailability of data from studies. Also there are no studies that have used other common OTCs used for cough, such as antihistamines and antitussives.

Thus, there is insufficient evidence to draw any conclusions about whether OTC medications taken as an adjunctive treatment for cough associated with acute pneumonia are beneficial or not. Mucolytics may be beneficial but the lack of consistent evidence precludes recommending the routine use of mucolytics as an adjunct in the treatment of troublesome cough associated with pneumonia in children or adults.
Keyword Adolescent
Anti-Bacterial Agents [therapeutic use]
Antitussive Agents [therapeutic use]
Chemotherapy, Adjuvant
Cough [drug therapy]
Expectorants [therapeutic use]
Nonprescription Drugs [therapeutic use]
Pneumonia [drug therapy]
Randomized Controlled Trials as Topic
Adult
Child
Humans
Respiratory-Tract Diseases
Metaanalyses
Bromhexine
Guacetisal
Erdosteine
Drug
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Faculty of Health and Behavioural Sciences -- Publications
Official 2013 Collection
 
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Created: Mon, 13 May 2013, 14:06:11 EST by Matthew Lamb on behalf of School of Medicine