A concept that is worth highlighting is the importance of treating cough to avoid the development of persistent cough.
Acute and sub acute cough
The Food and Drug Administration (FDA) issued a warning for parents and health workers against the use of OTC products for cough and common colds in infants and children under 2 years of age because of serious side effects and the potential danger to life that may arise as a result of their use in children
As far as the level of benefit is concerned, the effects of peripherally acting anti-tussives, such as levodropropizine and moguisteine, compare favorably with centrally-acting drugs, based on the evidence from clinical trials and according to the available clinical practice guidelines
peripheral anti-tussive drugs have been recommended for the treatment of acute and sub-acute cough, both in children and adults
However, under certain circumstances, the cause of cough is not treatable, even if it is known (e.g., endobronchial lung cancer or pulmonary fibrosis)
In such situations, a non-specific (symptomatic) anti-cough therapy for symptomatic relief seems appropriate
limited efficacy, intolerable side effects, or both
guidelines for chronic cough from both the U.S., and Europe, recommend the empiric use of inhaled corticosteroids for adult patients when treating cough due to asthma
proton pump inhibitors when the cough is associated with GERD
and first-generation anti-histamines when it is subsequent to an the upper airway syndrome
The American College of Chest Physicians (ACCP) issued their evidence based "Guidelines on Cough" in 2006
which state that anti-tussive drugs related with therapy of acute or chronic bronchitis showing the highest level of benefit were levodropropizine and moguisteine, that act through a peripheral mechanism, while the central antitussive drugs such as codeine and dextromethorphan showed a lower level of benefit.
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