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GPs go forth

No evidence that persistent cough treatments help patients, finds study

There is no evidence that medications for persistent cough help patients, researchers have said.

A study team from the University of Basel carried out a systematic review into the effectiveness of drugs used to treat persistent cough and found none were beneficial.

The paper, published in the BJGP, analysed six randomised control trials - including 724 patients - which assessed the benefits and harms of seven different treatment regimens for subacute cough.

The treatments were montelukast, salbutamol plus ipratropium bromide, oral gelatine, fluticasone propionate, budesonide, and nociception opioid 1 receptor agonist and codeine.

However, they found that no treatment option benefitted cough recovery or other patient-relevant outcomes – such as lung function, absence from work, and perception of improvement - at 14 days or 28 days. 

Adverse events were reported for 14% of patients across all treatments but the researchers also noted that the reporting quality within the studies was ‘frequently poor’.

The paper said: ‘Overall, this systematic review clearly emphasises the limited available evidence on therapeutic options for subacute cough.

‘However, it also shows that the symptoms diminish over time as a natural course of the self-limiting disease.’

It added: ‘This review indicates that, despite being one of the most common causes for seeking medical advice in primary care, there is no beneficial treatment for subacute cough.’

This comes after NICE draft guidance said that GPs should recommend honey, herbal remedies and certain cough medicines for patients with acute cough.

Readers' comments (1)

  • Curious, since I would not consider any of the treatments listed as therapy for a subacute cough!
    In Britain, apart from the fact patients will demand 3 or 4 courses antibiotics, and back it up with GMC complaints if not supplied, NICE-recommended management of a chronic cough (over 2-3 weeks?) is to refer to chest clinic and HRCT chest scanning, I think?

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