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Inhaled corticosteroids for subacute cough in children (Review)

Anderson-James, Sophie, Marchant, Julie M., Acworth, Jason P., Turner, Cathy and Chang, Anne B. (2013). Inhaled corticosteroids for subacute cough in children (Review). Cochrane Database of Systematic Reviews,2013(2):1-25.

Document type: Journal Article
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NHMRC Grant No. 545216
Title Inhaled corticosteroids for subacute cough in children (Review)
Author Anderson-James, Sophie
Marchant, Julie M.
Acworth, Jason P.
Turner, Cathy
Chang, Anne B.
Journal Name Cochrane Database of Systematic Reviews
Publication Date 2013
Volume Number 2013
Issue Number 2
ISSN 1469-493X   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84875506103
Start Page 1
End Page 25
Total Pages 25
Place of Publication United Kingdom
Publisher John Wiley & Sons Ltd.
Abstract Background
Cough is the most common symptom presenting to primary healthcare services. Cough in children is associated with significant morbidity for both children and their parents. While inhaled corticosteroids (ICS) can potentially reduce cough associated with airway inflammation and airway hyper-reactivity, use of ICS in children is not without potential adverse effects. Therefore, it would be beneficial to clinical practice to evaluate the evidence for the efficacy of ICS in reducing the severity of cough in children with subacute cough (defined as cough duration of two to four weeks) systematically.

To evaluate the efficacy of ICS in reducing the severity of cough in children with subacute cough.

Search methods
The Cochrane Register of Controlled Trials (CENTRAL), the Cochrane Airways Group Specialised Register, MEDLINE, EMBASE, review articles and reference lists of relevant articles were searched. The latest searches were performed in November 2011.

Selection criteria
All randomised controlled trials (RCTs) comparing ICS with a control group in children with subacute cough were considered for inclusion.

Data collection and analysis
Search results were reviewed against pre-determined criteria for inclusion. Two sets of review authors independently selected, extracted and assessed the data for inclusion. Study authors were contacted for further information where required. Data were analysed as 'intention to treat'.

Main results
The search identified 1178 potentially relevant titles; however, there were no published studies that were specifically designed to answer this question. Two studies met criteria for inclusion in the review and 98 children were included in the meta-analysis. There was no significant difference between groups in the proportion of children 'not cured' at follow-up (primary outcome measure), with a pooled odds ratio (OR) of 0.61 (95% confidence interval (CI) 0.24 to 1.55). However, the included studies were limited in their ability to answer the review question by the fact that all participants were infants, post acute bronchiolitis illness, and cough duration at the start of study medication was ill-defined.

Authors' conclusions
There is currently no evidence to support the use of ICS for treatment of subacute cough in children. However, this systematic review is limited by the small number of studies available for analysis and the size, quality and design of these studies. Further well-designed RCTs are required to support or refute the efficacy of treatment with ICS in children with subacute cough.
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Additional Notes Copyright © 2013 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd.

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