European Respiratory Society Annual Congress 2013 Abstract Number: 2089 Publication Number: P1208 Abstract Group: 7.4. Paediatric Respiratory Infection and Immunology Keyword 1: Children Keyword 2: Cough Keyword 3: Pharmacology

Title: Antibiotic or symptomatic therapy in URTI-related pediatric acute cough?

Dr. Alessandro 18512 Zanasi [email protected] MD 1, Dr. Luigi 18513 Lanata [email protected] MD 2, Dr. Francesco 18514 De Blasio [email protected] MD 3, Dr. Federico 18515 Saibene [email protected] MD 2, Dr. Giovanni 18516 Fontana [email protected] MD 5, Dr. Rossella 18539 Balsamo [email protected] MD 2 and Dr. Peter 18517 Dicpinigaitis [email protected] MD 4. 1 Pneumology Unit, University of Bologna, S.Orsola Malpighi Hospital, Bologna, Italy ; 2 Medical Department, Dompé SPA, Milan, Italy ; 3 Respiratory Medicine and Pulmonary Rehabilitation Section, Clinic Center, Private Hospital, Naples, Italy ; 4 Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States and 5 Medical Department, University of Florence, Careggi Hospital, Florence, Italy .

Body: Acute cough is a widespread symptom in children, the disproportionate use of antibiotic prescription increases parental satisfaction, although URTI are generally self-limiting. We analyzed treatment effect of antibiotics and symptomatic drugs (antitussives and mucolitics) in two trials on URTI-related cough. The first retrospective study involved 59 children with acute moist cough, treated with antibiotics or inhaled mucoactive drugs. Cough was measured, by means of a verbal category descriptive (VCD) score. The second prospective study included 305 children with acute cough. Severity, frequency and type of cough were assessed after 6 days of treatment using a standardized questionnaire. In the retrospective series, patients treated with inhaled mucoactive drugs (sobrerol or N-) showed a significant improvement after 7 days compared with the group receiving antimicrobial therapy (p<0,01). In the prospective study children treated with antibiotics alone showed lower percentage of cough resolution after 6 days than patient treated with antitussive only, no difference was detected between children treated with antitussive alone vs patients receiving antibiotics and antitussives. The use of demonstrated a statistically significant effect in terms of cough resolution as compared to centrally acting antitussive drugs ( or ) (47% vs. 28%, p = 0.0012). Our analysis of the studies showed that the effect of antibiotics on acute cough caused by URTI is inferior to symptomatic therapy. Antibiotics are not generally useful for treating cough, both alone and in association with antitussives. Mostly antibiotics is of little benefit and is outweighed by the adverse effects.