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Inhaled corticosteroids for non-specific chronic cough in children
A A T Tomerak1, J J M McGlashan, H H V Vyas
1Queen's Medical Centre, Department of Child Health, Derby Road, Nottingham, UK NG7 2UH. ahmedtomerak@hotmail.com
The Cochrane Database of Systematic Reviews
|October 20, 2005
Summary
Inhaled corticosteroids showed no significant benefit for non-specific cough in children. A small improvement in nocturnal cough was observed with higher doses, but placebo also showed effects, questioning clinical significance.
Area of Science:
- Pediatric Pulmonology
- Clinical Pharmacology
Background:
- Non-specific cough in children, often termed cough variant asthma, lacks a clear etiology.
- Therapeutic trials with asthma medications are sometimes used to diagnose underlying asthma.
Purpose of the Study:
- To evaluate the effectiveness of inhaled corticosteroids for treating non-specific cough in children over two years of age.
Main Methods:
- Systematic review of randomized controlled trials from CENTRAL, MEDLINE, and EMBASE databases (searches current as of March 2004).
- Inclusion criteria: randomized trials of inhaled corticosteroids (beclomethasone, fluticasone, triamcinalone) for cough in children >2 years.
- Two independent reviewers assessed study eligibility and quality; data extracted using RevMan software.
Main Results:
- Two trials (123 participants) met inclusion criteria, comparing inhaled corticosteroids with placebo using metered dose inhalers with spacers.
- Low-dose beclomethasone (400 mcg/day) showed no significant difference from placebo.
- High-dose fluticasone showed a significant improvement in nocturnal cough frequency after two weeks, though placebo also yielded a smaller improvement.
Conclusions:
- Beclomethasone dipropionate (400 mcg/day) was not superior to placebo for reducing cough frequency.
- While very high-dose inhaled corticosteroids may offer a marginal improvement, their clinical benefit is questionable.