An observational study on cough in children: epidemiology, impact on quality of sleep and treatment outcome

Francesco De Blasio,Alessando Zanasi,Luigi Lanata,Gianluca De Danieli,Bruce K Rubin,Peter V Dicpinigaitis

doi:10.1186/1745-9974-8-1

Abstract

BackgroundCough is one of the most frequent symptoms in children and is the most common symptom for which children visit a health care provider.MethodsThis is an observational study on acute cough associated with upper respiratory tract infection (URTI) in children. The study evaluates the epidemiology and impact of cough on quality of sleep and children's activities, and the outcome of cough with antitussive treatments in pediatric routine clinical practice. Study assessments were performed through a pediatric cough questionnaire (PCQ), developed by the Italian Society of Cough Study. A total of 433 children visited by family care pediatricians for acute cough due to a URTI were enrolled in this study, with mean age of 6.1 years (SD 3.6). Cough type, duration, severity and frequency, cough impact on sleep disturbances of children and parents and on school and sport activities were assessed at baseline. In a subset of 241 children who were either treated with antitussive drugs (levodropropizine n = 101, central antitussives n = 60) or received no treatment (n = 80), the outcome of cough after 6 days was analyzed in terms of resolution, improvement, no change, or worsening. Descriptive analysis, χ2 test, and multivariate analysis with stepwise logistic regression were performed.ResultsCough disturbed sleep in 88% of children and 72% of parents. In children treated with cough suppressants, the duration, type, intensity, and frequency cough were similar at baseline in the two groups respectively treated with levodropropizine and central antitussives (cloperastine and codeine). Both levodropropizine and central drugs reduced cough intensity and frequency. However, percentage of cough resolution was higher with levodropropizine than with central antitussives (47% vs. 28% respectively, p = 0.0012).ConclusionsAcute cough disturbs sleep in most children and their parents. Both levodropropizine and central antitussives reduced cough intensity, with levodropropizine producing a higher cough resolution rate.

Highlights

Cough is one of the most frequent symptoms in children and is the most common symptom for which children visit a health care provider
Among antitussive drugs available for the treatment of cough in children, codeine and cloperastine are centrally acting agents that are believed to inhibit cough primarily by their effect on the cough center, while levodropropizine is a non-opioid agent whose suggested peripheral antitussive action may result from inhibition of the cough reflex at the peripheral nerve level [7] with possible modulation of sensory neuropeptide levels within the respiratory tract [8]
The aim of this study was to evaluate the epidemiology of acute cough associated with upper respiratory tract infection (URTI) in children, the impact of acute cough on quality of sleep of children and their parents, the impact of acute cough on children’s sport and school activities, and acute cough outcome with antitussive treatments

Summary

Introduction

Cough is one of the most frequent symptoms in children and is the most common symptom for which children visit a health care provider. Cough is one of the most frequent symptoms in children [1,2] and is one of the most common reasons for which parents seek medical attention for their child [3]. Acute cough is due to viral upper respiratory tract infection (URTI), i.e., the common cold [4]. Cough resulting from URTI may be a distressing symptom, and empiric treatment with antitussive agents is often used [6]. The aim of this study was to evaluate the epidemiology of acute cough associated with URTI in children, the impact of acute cough on quality of sleep of children and their parents, the impact of acute cough on children’s sport and school activities, and acute cough outcome with antitussive treatments Among antitussive drugs available for the treatment of cough in children, codeine and cloperastine are centrally acting agents (opioids and non opioids) that are believed to inhibit cough primarily by their effect on the cough center, while levodropropizine is a non-opioid agent whose suggested peripheral antitussive action may result from inhibition of the cough reflex at the peripheral nerve level (sensory Cfibres) [7] with possible modulation of sensory neuropeptide levels within the respiratory tract [8].

Objectives

Methods

Results