Antibiotics best treatment for children's chronic wet cough

Antibiotics are the most effective treatment for prolonged wet cough in children, according to the results of a meta-analysis published in Cochrane.

Julie M Marchant and associates did a meta-analysis to determine the efficacy of antibiotics in treating children with prolonged wet cough (excluding children with bronchiectasis or other known underlying respiratory illness) and to assess the risk of harm due to adverse events.

The meta-analysis included randomized controlled trials (RCTs) comparing antibiotics with a placebo or a control group in children with chronic wet cough. The investigators included 190 children (171 completed), mean ages ranged from 21 months to six years, in the meta‐analyses. The authors found three studies that varied in a number of ways including different antibiotics (two studies used amoxicillin/clavulanate acid and one used erythromycin) and length of treatment was seven or 14 days.

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Key study findings:

• Analysis of all three trials (190 children) found that treatment with antibiotics reduced the proportion of children not cured at follow‐up.


• The cure rate was one child cured for every three children treated.


• All three trials (190 children) reported adverse events, which were not significantly increased in the antibiotic group compared to the control.


• Children who received antibiotics were significantly less likely to have progression of illness, defined by the requirement for further antibiotics, compared to children who did not receive antibiotics.

The study concluded that antibiotics are effective in treating children with chronic (greater than four weeks) wet cough and could be considered when they present to doctors.

Internationally cough is consistently the most common symptom for presentation to primary care physicians. Chronic childhood cough is defined as a cough lasting more than four weeks. In addition to the classification based on duration, cough can be classified as wet/productive or dry. Antibiotics are the mainstay of treating bacterial infections for all ages. There are different forms of antibiotics that can be used for respiratory system infections; oral (suspension, tablets, capsules), inhaled or intravenous.

For reference log on to https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004822.pub3/full