1 October 2009

Coughs and colds in young children can be a major burden on many families. In the latest edition of Australian Prescriber, Dr Valerie Sung and Dr Noel Cranswick from the Royal Children’s Hospital in Melbourne consider the evidence against cough products for children and suggest alternative remedies that parents can try.

“When a child goes to the doctor with cough or cold symptoms, the most important first step is to make the correct diagnosis and exclude serious causes. Management of a cough should be directed at the underlying case,” the authors write.

In September 2008 cough and cold medicines for children under two years were rescheduled to ‘prescription only’. The USA and the UK have introduced similar restrictions in response to reports of side effects, accidental overdoses and lack of evidence that they are actually effective in young children.

“It is well known that cough and cold products in children are a major cause of unintentional drug overdoses, and are associated with sudden infant deaths,” the authors write.

A recent Cochrane review found treatments were no more effective than placebo for acute cough in children and adults, however other studies have been less conclusive.

“Data on the effectiveness of cough and cold medicines in children under two years old are extremely limited. There is no reliable evidence to recommend their use in this age group,” say Dr Sung and Dr Cranswick.

“Parents should also understand that these remedies will not change the course of their child’s illness, and may cause unwanted side effects such as drowsiness, headaches and vomiting,” they warn.

Other treatments which should be considered include adequate fluids and rest, saline drops for nasal infections, and honey in children over one year old.

”Cough and cold medicines must be avoided in children under two years and should not be recommended in children of any age,” the authors conclude.

To read the full article, which includes a table listing the potential side effects for different cough medicines, visit www.australianprescriber.com.

ENDS

Australian Prescriber is an independent peer-reviewed journal providing critical commentary on therapeutic topics for health professionals, particularly doctors in general practice. It is published by National Prescribing Service Limited (NPS), an independent, non-profit organisation for Quality Use of Medicines funded by the Australian Government Department of Health and Ageing.