CHEST Guidelines-Pharmacologic-and-Nonpharmacologic-Treatment-for-A

Pharmacologic-and-Nonpharmacologic-Treatment-for-A

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The CHEST Expert Panel Report examines treatments for acute cough associated with the common cold (CACC), updating the 2006 guidelines based on a systematic review of randomized controlled trials (RCTs). The findings largely reveal that available evidence is of low quality, leaving treatment decisions to heavily rely on patient preferences and therapy availability. Recommendations and suggestions from the CHEST Panel discourage using over-the-counter (OTC) cough and cold medicines in both adults and children unless evidence shows they effectively reduce cough severity or shorten its duration.<br /><br />Notable suggestions include avoiding NSAIDs in adults and highlighting honey as a potentially useful nonpharmacologic option in children aged 1-18. Honey, however, should not be administered to infants under 1 year, and dextromethorphan should not be used in children under 2 years. The report also suggests avoiding codeine-containing medications for children under 18 due to risks of serious side effects, including respiratory distress.<br /><br />OTC cough treatments examined include antitussives, expectorants, and mucolytic agents, with the evidence not supporting their efficacy in reducing cough duration associated with the common cold. Zinc lozenges showed some effect in reducing symptom duration but only in adults and not consistently.<br /><br />Research gaps identified for future exploration include studies to validate the effectiveness of multi-component treatments, development of effective antitussives for children, and RCTs with proper comparators.<br /><br />Additionally, safety concerns related to certain medications are noted, particularly the use of codeine and combinations involving opioids. These concerns underline the importance of remaining informed about FDA guidelines and product warnings. Despite diverse treatment options, the report concludes that many fail to demonstrate clear efficacy in clinical studies, necessitating further research.

Keywords

acute cough

common cold

CHEST Expert Panel

treatment guidelines

over-the-counter medicines

honey

dextromethorphan

codeine

RCTs

safety concerns