Trained study coordinators were responsible for survey administration, and survey responses ranged from most severe symptoms (7 points) to no symptoms (1 point). Subjective parental assessments of their child’s symptoms on the previous night were assessed after informed consent was obtained through a modified version of our previously used and validated questions 15 by using a 7-point Likert scale ( Fig 1). 13 Finally, subjects were excluded if on the night before enrollment they used OTC or prescription medication that contained VR components, pseudoephedrine, phenylephrine, dextromethorphan, guaifenesin, diphenhydramine, brompheniramine, chlorpheniramine, or honey. Children with seizure disorders were excluded because of the reported association of camphor with seizures, particularly after ingestions of toxic amounts. They were also ineligible with a history of asthma, chronic lung disease, or a seizure disorder. ![]() Patients were excluded for signs or symptoms of a more treatable disease (eg, asthma, pneumonia, laryngotracheobronchitis, sinusitis, allergic rhinitis). Eligible patients were aged 2 to 11 years with symptoms attributed to URIs characterized by cough, congestion, and rhinorrhea that lasted 7 days or longer. We hypothesized that VR or petrolatum would be superior to no treatment for relief of nocturnal symptoms and that VR would be superior to petrolatum.įrom October 2008 through February 2010, patients were recruited from a university-affiliated pediatric practice in Hershey, Pennsylvania. With no contemporary evidence that supports or refutes the efficacy in children with URIs, this study sought to determine if a single application of a vapor rub (VR) or petrolatum is superior to no treatment for nocturnal cough, congestion, and sleep difficulty caused by URIs. 4 Dextromethorphan continues not to be recommended, 14 and therefore the question of whether clinicians can recommend topical preparations containing camphor, menthol, and eucalyptus oil for URI symptoms in children requires reevaluation. 8– 12Ĭommenting on camphor-containing products, in 1994 the American Academy of Pediatrics Committee on Drugs wrote, “Since alternative agents exist for all indications for camphor therapy, other therapeutic agents that do not contain camphor should be considered.” 13 The “alternative agent” for cough and cold symptoms cited by the Committee in 1994, dextromethorphan, was subsequently not recommended by that committee 3 years later in a policy statement on dextromethorphan use. Alternatives to oral medications are popular topical preparations that contain menthol, camphor, and eucalyptus oils and have been used in adults and children for more than a century. Clinicians and parents have been left with limited therapeutic options to administer to children with these disruptive symptoms. Recent studies 2, 3 and guidelines 4– 7 have questioned the efficacy of many oral over-the-counter (OTC) treatments for URI symptoms. In addition to attempting to improve their comfort, giving medications to children before bed is often an attempt by parents to improve their own sleep and functioning during the subsequent day. The characteristic features of URIs are often adversely affected sleep for both ill children and their parents with an effect on subsequent daytime activities. ![]() doi:10.Upper respiratory infections (URIs) are the most common acute illnesses in the world, 1 and symptoms caused by these infections are disruptive for children. Comparing the effectiveness of honey consumption with anti-cough medication in pediatric patients: a systematic review. National Institute of Diabetes and Digestive and Kidney Diseases. Narrative review: how long should patients with cough variant asthma or non-asthmatic eosinophilic bronchitis be treated? J Thorac Dis. doi:10.1007/978-5-7_5Ĭenters for Disease Control and Prevention. Allergic respiratory inflammation and remodeling. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. Morice AH, Millqvist E, Bieksiene K, et al. COVID-19 infection, the COVID-19 pandemic, and changes in sleep. ![]() Classification of cough as a symptom in adults and management aalgorithms: CHEST guideline and Expert Panel report. Irwin RS, French CL, Chang AB, Altman KW CHEST Expert Cough Panel*. Pinyochotiwong C, Chirakalwasan N, Collop N. Environmental triggers of nocturnal dry cough in infancy: new insights about chronic domestic exposure to formaldehyde in the PARIS birth cohort. Understanding gastroesophageal reflux disease. American Society for Gastrointestinal Endoscopy.
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