Rupert, one of the chiros writes:
The most common ‘condition’ in the world is upper respiratory tract infections, so coughs and colds to you and me. And, how do we deal with these, well, for decades over the counter (OTC) medications have been developed and sold for the relief of the associated symptoms.
Now, because these medications are OTC there has been less than rigorous control of them, though in 2007 the FDA did recommend that they not be used for children under six.
But how good are they? The evidence gives a consistent message relative to the effectiveness of these OTC medications both for adults and children. The message is that they are not effective and could potentially cause harm. There are, however, other more natural approaches that appear to be effective in relieving the associated symptoms of upper respiratory infections.
A Cochrane Review of the effectiveness of OTC also concluded that
“There is no good evidence for or against the effectiveness of OTC medicines in acute cough”.
In yet another study comparing two common medications, Diphenhydramine and dextromethorphan (DM), with no treatment found:
“Diphenhydramine and dextromethorphan are not superior to placebo in providing nocturnal symptom relief for children with cough and sleep difficulty as a result of an upper respiratory infection. Furthermore, the medications given to children do not result in improved quality of sleep for their parents when compared with placebo. Each clinician should consider these findings, the potential for adverse effects, and the individual and cumulative costs of the drugs before recommending them to families.”
Which is just crazy. Why do we do it, well it’s “the economy stupid”. Millions of pounds and dollars are spent promoting cough suppressants and other medications for relief of coughs and colds and the profits are staggering. Dr Richard Russell, of the British Thoracic Society, said:
“Over-the-counter sales for acute cough medicines currently reach approximately £100m a year in the UK – money that is being spent on remedies, where there is no evidence that they work.”
So now, I’d suggest, the use of these products is engrained in our culture and it will take years of patient education and perhaps more action by the authorities to reduce the risk to society they pose.
At the other end of the scale look at this gem: A clinical trial comparing honey, dextromethorphan and no treatment found that:
“…parents rated honey most favourably for symptomatic relief of their child’s nocturnal cough and sleep difficulty due to upper respiratory tract infection.”
oh, sorry, I meant:
In a comparison of honey, DM, and no treatment, parents rated honey most favourably for symptomatic relief of their child’s nocturnal cough and sleep difficulty due to upper respiratory tract infection. So, simple honey may be a preferable treatment for the cough and sleep difficulty associated with childhood upper respiratory tract infection than the drugs.
And, in a more recent trial (November 2010) a simple vapour rub, petrolatum and no treatment were compared and the authors concluded that:
“Despite mild irritant adverse effects, VR provided symptomatic relief for children and allowed them and their parents to have a more restful night than those in the other study groups.”
