Wednesday, July 07, 2004

Best remedy for a child's cough? Water
Over-the-counter syrups are a waste of money, study says

SEATTLE POST-INTELLIGENCER NEWS SERVICES
(Original Story)

A glass of water will do as much to relieve a child's cough as an expensive, over-the-counter cough syrup, a new study suggests.

The research, published in the medical journal Pediatrics, concludes that parents who treat a child's nighttime cough with the widely available medications are wasting their money.

"Consumers spend billions of dollars each year on over-the-counter medications for cough," said Ian Paul, an assistant professor of pediatrics at Penn State Children's Hospital in Hershey, Pa.

NOTE: This article has been updated since it was originally published in the newspaper.
"But our study showed that the two ingredients used in most over-the-counter medications were no better than a placebo, non-medicated syrup, in providing nighttime relief for children with cough and sleep difficulty as a result of upper-respiratory infection," he said.

About 95 percent of syrups, including the best-selling brands Benylin DM and Robitussin, have dextromethorphan as their active ingredient. It is an antitussive, which suppresses coughing. Other cough syrups contain diphenhydramine, an antihistamine, designed to reduce swelling in the respiratory tract. (Note: An incorrect description of dextromethorphan was given in the original version of this article.)

To conduct the study, researchers recruited 100 children with upper-respiratory-tract infections who had been coughing for an average of more than three days.

The children were given one of three treatments 30 minutes before bedtime: a cough syrup containing dextromethorphan, a cough syrup containing diphenhydramine or a placebo syrup.

Children in all three groups showed a dramatic reduction in cough frequency, but those taking the placebo -- essentially flavored water -- had the best results. On four other measures, the three treatments had virtually identical outcomes.

Paul said this demonstrates that time and proper hydration are the best treatment for most respiratory infections and that the benefit that comes from cough syrups is likely psychological.

The study confirms what many physicians already know. In fact, the Merck Manual of Diagnosis and Therapy, a reference book used by physicians and written by an editorial board of medical experts, says there is little evidence that cough syrups provide any benefit.

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