CHEST Guidelines-Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold

Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold

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The CHEST Expert Panel Report 2017 addresses the treatment of acute cough associated with the common cold (CACC), a prevalent condition that affects quality of life. This report updates the 2006 guidelines through a systematic review of randomized controlled trials (RCTs) to evaluate the efficacy of pharmacologic and nonpharmacologic treatments.<br /><br />Key findings include:<br /><br />1. Over-the-Counter (OTC) Medicines: For both adults and children, using OTC cough and cold medicines is discouraged until proven effective in reducing cough severity or duration.<br /><br />2. Nonsteroidal Anti-inflammatory Drugs (NSAIDs): In adults, there's insufficient evidence supporting NSAIDs for CACC treatment.<br /><br />3. Honey: For children aged 1-18, honey may provide more relief than no treatment or diphenhydramine, but not more than dextromethorphan. Honey is not recommended for infants under 1 year, and dextromethorphan is not recommended for children under 2 years.<br /><br />4. Codeine-containing Medications: Advising against use in children under 18 years because of the risk of serious side effects, including respiratory distress.<br /><br />5. Zinc: The evidence is inconsistent for using zinc lozenges in healthy adults to reduce cold symptom duration, including cough.<br /><br />6. Overall, the quality of the evidence was low, and the panel provided guidance primarily based on clinical judgment and patient preferences.<br /><br />The panel emphasizes the need for more high-quality research on effective treatments for CACC, particularly on new formulations and safer alternatives for vulnerable populations like children. It also highlights a significant gap in the evidence regarding the efficacy of many existing treatments, urging cautious use and consideration of known risks.<br /><br />The recommendations align with concerns about using certain medications in young children due to potential side effects and suggest further exploration into developing validated, effective antitussive treatments.

Keywords

acute cough

common cold

CACC

OTC medicines

NSAIDs

honey

codeine

zinc lozenges

RCTs

antitussive treatments