CHEST Guidelines-Pharmacologic-and-Nonpharmacologic-Treatment-for-A (1)

Pharmacologic-and-Nonpharmacologic-Treatment-for-A (1)

Pdf Summary

The CHEST Expert Panel Report provides updated guidance on treating acute cough associated with the common cold (CACC). The systematic review evaluated pharmacologic and nonpharmacologic treatments to manage CACC, covering studies involving 6,496 participants. The overall quality of the evidence was low, yielding several general suggestions:

1. <strong>OTC Medicines</strong>: The report suggests avoiding over-the-counter (OTC) cough and cold medicines in both adults and children until they demonstrate a significant reduction in cough severity or duration.
   
2. <strong>NSAIDs</strong>: For adults, nonsteroidal anti-inflammatory drugs (NSAIDs) are also discouraged due to lack of evidence showing effectiveness in alleviating cough symptoms.
   
3. <strong>Honey for Children</strong>: Honey is favored over no treatment, diphenhydramine, or placebo for children aged 1-18 years, with better efficacy observed in alleviating cough symptoms, although it is not superior to dextromethorphan. It is advised not to give honey to infants under 1 year or dextromethorphan to children under 2 years.

4. <strong>Codeine in Children</strong>: The panel suggests avoiding codeine-containing medications for children due to potential respiratory distress risks.

The report highlights that CACC significantly affects quality of life and is a predominant reason for medical visits, with cough typically being a lingering symptom. Existing treatments largely consist of OTC products and recently approved prescription combinations, which have raised safety concerns, especially for children.

Despite numerous treatment options, limitations in the data make it difficult to recommend specific therapies. The report emphasizes the need for future research to improve treatment options, especially investigations into effective therapies and potential risks associated with current treatments. Overall, the guidelines underscore the importance of basing cough treatments on solid evidence, accounting for patient preferences and potential risks.

Keywords

acute cough

common cold

OTC medicines

NSAIDs

honey treatment

codeine risks

children cough

cough management

evidence-based guidelines

pharmacologic treatments