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- W183176003 abstract "Editor—Schroeder and Fahey are right to urge caution in interpreting the results of their systematic review on cough medicines, and their recommendation to change existing guidance on cough medicines in the United Kingdom is not justified.1Their review considered a heterogeneous group of products that included many different active ingredients from several different drug classes. It is surely impossible to draw from this any meaningful conclusions about over the counter cough medicines as a whole. Many of the products and active ingredients in the reviewed trials are either not available at all in the United Kingdom (moguisteine, bromhexine), are only available on prescription (salbutamol, terfenadine), or are not indicated for the relief of cough (loratidine, terfenadine).Only 15 trials were included in the review, and only one reported a power calculation. As the authors concede, it seems highly likely that many of the remainder did not include sufficient patients to detect a difference from placebo, should one exist. The predictable upshot of this is that the review showed no evidence of effect—not evidence of no effect, as many will have inferred.All the review really shows is the lack of good quality research on over the counter cough medicines. This should not surprise anybody, as most of the active ingredients in these medicines are old enough to have lost patent protection, and there are more pressing items on the research agenda. Patients derive enough benefit from over the counter cough medicines to purchase them in the first place and to keep returning for more. This in itself is evidence, although not of the double blind, randomised, placebo controlled variety.If current advice on cough medicines is changed to appease the evidence based medicine purists, patients with uncomplicated upper respiratory tract infection are likely to consult their doctor. Not only is this an unnecessary use of a scarce resource but it is also likely to increase the number of inappropriate prescriptions for antibiotics." @default.
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- W183176003 date "2002-05-11" @default.
- W183176003 modified "2023-10-16" @default.
- W183176003 title "Over the counter cough medicines for acute cough" @default.
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- W183176003 doi "https://doi.org/10.1136/bmj.324.7346.1158" @default.
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