Pediatrics |

Acute Cough in Children: The Role of Antibiotics FREE TO VIEW

Alessandro Zanasi, MD; Francesco De Blasio, MD; Gianluca De Danieli, MD; Luigi Lanata, MD; Francesco De Blasio*, PhD
Author and Funding Information

Pneumology Unit, University of Bologna, S. Orsola Malpighi Hospital, Bologna, Italy

Chest. 2012;142(4_MeetingAbstracts):774A. doi:10.1378/chest.1372825
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SESSION TYPE: Pediatric Pulmonology Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Acute airways infections are a major cause of morbidity in infancy, and the common cold represents the major cause of cough. While there is evidence that an early antibiotic prescription for children with coughing “head colds” increases parental satisfaction, evidence available in the literature up to now does not show any beneficial effect of antibiotics that, on the contrary, may be associated with side effects.

METHODS: We conducted an observational study in children who required a specific paediatric consultation for acute cough.The use of antibiotics was reported on the CRF. One of the aims of this observational study was to focus on the use of antibiotics in this clinical setting. Data from 305 children with complaint of cough due to common cold were analyzed to evaluate the treatment outcomes. Eighty nine children received antibiotics only, while 38 children received combination of antibiotics and antitussives; central (codeine or cloperastine) in 16 cases, and peripheral (levodropropizine) in 22 children, respectively. Forty four and 79 children received only central or peripheral anitussives respectively, without antibiotics.

RESULTS: No difference in the percentage of patients who achieved cough resolution between those treated with antitussive alone vs patients receiving a combination of antibiotics and antitussive, either for central and peripheral antitussives. Patients treated with antibiotics only showed lower percentage of cough resolution than children treated with antitussive only. The use of levodropropizine demonstrated a statistically significant beneficial effect in terms of resolution of cough symptoms as compared to centrally acting antitussive drugs (codeine or cloperastine) (47% vs. 28%, p = 0.0012).

CONCLUSIONS: Antibiotics are not generally useful for treating acute cough caused by simple “head colds”, both alone and in association with antitussive drugs. An interventional strategy focused on doctor-patient communication and patient empowerment is an effective concept to reduce this disproportionate use of these drugs. Levodropropizine showed to be an effective antitussive drug on cough symptoms associated to common colds with an advantage vs. central cough suppressants in terms of higher cough resolution rate and lower probability of unsuccessful treatment This study was supported by Dompé S.P.A., Italy (unrestricted grant)

CLINICAL IMPLICATIONS: We wanted, through this study, to underline the role of the use of antibiotics in pediatric patients with cough due to URTI's

DISCLOSURE: Gianluca De Danieli: Employee: Medical Manager Dompè spa

Luigi Lanata: Employee: Medical Director Dompè spa

The following authors have nothing to disclose: Alessandro Zanasi, Francesco De Blasio, Francesco De Blasio

No Product/Research Disclosure Information

Pneumology Unit, University of Bologna, S. Orsola Malpighi Hospital, Bologna, Italy




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