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Gill PJ, Onakpoya IJ, Buchanan F, Birnie KA, Van den Bruel A. Treatments for cough and common cold in children. BMJ 2024; 384:e075306. [PMID: 38272497 DOI: 10.1136/bmj-2023-075306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Affiliation(s)
- Peter J Gill
- The Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto
- Department of Paediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Igho J Onakpoya
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Kathryn A Birnie
- Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary
- Alberta Children's Hospital Research Institute, Calgary
| | - Ann Van den Bruel
- Academic Centre for Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium
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Sumer J, Keckeis K, Scanferla G, Frischknecht M, Notter J, Steffen A, Kohler P, Schmid P, Roth B, Wissel K, Vernazza P, Klein P, Schoop R, Albrich WC. Novel Echinacea formulations for the treatment of acute respiratory tract infections in adults-A randomized blinded controlled trial. Front Med (Lausanne) 2023; 10:948787. [PMID: 37138742 PMCID: PMC10150997 DOI: 10.3389/fmed.2023.948787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 03/16/2023] [Indexed: 05/05/2023] Open
Abstract
Background Echinacea purpurea has clinical antiviral activity against respiratory viruses and modulates immune functions. In this study, we compared higher doses of new Echinacea formulations with conventional formulations at lower, preventive doses for therapy of respiratory tract infections (RTIs). Methods In this randomized, blinded, controlled trial, healthy adults (n = 409) were randomized between November 2018 and January 2019 to one of four Echinacea formulations, which were taken in case of an RTI for up to 10 days. New formulations A (lozenges) and B (spray) delivered an increased dose of 16,800 mg/d Echinacea extract during days 1-3 and 2,240-3,360 mg/d afterward; as controls, conventional formulations C (tablets) and D (drops) delivered a lower daily dose of 2,400 mg, usually taken for prevention. The primary endpoint was time to clinical remission of first RTI episodes based on the Kaplan-Meier analysis of patient-reported, investigator-confirmed, respiratory symptoms assessed for up to 10 days. In a sensitivity analysis, the mean time to remission beyond day 10 was calculated by extrapolating the treatment effects observed on days 7 to 10. Results A total of 246 participants (median age 32 years, 78% female participants) were treated for at least one RTI. Recovery by day 10 (complete absence of symptoms) was achieved in 56 and 44% of patients with the new and conventional formulations, respectively, showing a median time to recovery of 10 and 11 days, respectively (p = 0.10 in intention-to-treat analysis, p = 0.07 in per-protocol analysis). In the extrapolated sensitivity analysis, new formulations resulted in a significantly shorter mean time to remission (9.6 vs. 11.0 days, p < 0.001). Among those with an identified respiratory virus, viral clearance until day 10 based on real-time PCR from nasopharyngeal swabs was more frequent with new formulations (70 vs. 53%, p = 0.046). Tolerability and safety (adverse events: 12 vs. 6%, p = 0.19) were good and similar between formulations. There was one severe adverse event with a potential hypersensitivity reaction in a recipient of the novel spray formulation. Conclusion In adults with acute RTI, new Echinacea formulations with higher doses resulted in faster viral clearance than conventional formulations in prophylactic dosages. The trend for faster clinical recovery was not significant by day 10 but became so upon extrapolation. A dose increase during acute respiratory symptoms might improve the clinical benefits of orally administered Echinacea formulations. Trial registration The study was registered in the Swiss National Clinical Trials Portal (SNCTP000003069) and on ClinicalTrials.gov (NTC03812900; URL https://clinicaltrials.gov/ct2/show/NCT03812900?cond=echinacea&draw=3&rank=14).
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Affiliation(s)
- Johannes Sumer
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Karin Keckeis
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Giulia Scanferla
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Manuel Frischknecht
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Julia Notter
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Ana Steffen
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Philipp Kohler
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Patrick Schmid
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Bianca Roth
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital of Lucerne, Luzern, Switzerland
| | | | - Pietro Vernazza
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Peter Klein
- d.s.h. Statistical Services GmbH, Rohrbach, Germany
| | | | - Werner C. Albrich
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
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Zhou Q, Luo Y, Zhu Y, Chen Q, Qiu J, Cong F, Li Y, Zhang X. Nonsteroidal anti-inflammatory drugs (NSAIDs) and nucleotide analog GS-441524 conjugates with potent in vivo efficacy against coronaviruses. Eur J Med Chem 2023; 249:115113. [PMID: 36706621 PMCID: PMC9830933 DOI: 10.1016/j.ejmech.2023.115113] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/25/2022] [Accepted: 01/09/2023] [Indexed: 01/11/2023]
Abstract
Coronaviruses (CoVs) infect a broad range of hosts, including humans and various animals, with a tendency to cross the species barrier, causing severe harm to human society and fostering the need for effective anti-coronaviral drugs. GS-441524 is a broad-spectrum antiviral nucleoside with potent anti-CoVs activities. However, its application is limited by poor oral bioavailability. Herein, we designed and synthesized several conjugates via covalently binding NSAIDs to 5'-OH of GS-441524 through ester bonds. The ibuprofen conjugate, ATV041, exhibited potent in vitro anti-coronaviral efficacy against four zoonotic coronaviruses in the alpha- and beta-genera. Oral-dosed ATV041 resulted in favorable bioavailability and rapid tissue distribution of GS-441524 and ibuprofen. In MHV-A59 infected mice, ATV041 dose-dependently decreased viral RNA replication and significantly reduced the proinflammatory cytokines in the liver and the lung at 3 dpi. As a result, the MHV-A59-induced lung and liver inflammatory injury was significantly alleviated. Taken together, this work provides a novel drug conjugate strategy to improve oral PK and offers a potent anti-coronaviral lead compound for further studies.
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Affiliation(s)
- Qifan Zhou
- Department of Chemistry, College of Science, Academy for Advanced Interdisciplinary Studies and Medi-X Pingshan, Southern University of Science and Technology, Shenzhen, Guangdong, 518000, China
| | - Yinzhu Luo
- Guangdong Province Key Laboratory of Laboratory Animals, Guangdong Laboratory Animals Monitoring Institute, Guangzhou, Guangdong, 510663, China
| | - Yujun Zhu
- Guangdong Province Key Laboratory of Laboratory Animals, Guangdong Laboratory Animals Monitoring Institute, Guangzhou, Guangdong, 510663, China
| | - Qishu Chen
- Department of Chemistry, College of Science, Academy for Advanced Interdisciplinary Studies and Medi-X Pingshan, Southern University of Science and Technology, Shenzhen, Guangdong, 518000, China
| | - Jingfei Qiu
- Department of Chemistry, College of Science, Academy for Advanced Interdisciplinary Studies and Medi-X Pingshan, Southern University of Science and Technology, Shenzhen, Guangdong, 518000, China
| | - Feng Cong
- Guangdong Province Key Laboratory of Laboratory Animals, Guangdong Laboratory Animals Monitoring Institute, Guangzhou, Guangdong, 510663, China.
| | - Yingjun Li
- Department of Chemistry, College of Science, Academy for Advanced Interdisciplinary Studies and Medi-X Pingshan, Southern University of Science and Technology, Shenzhen, Guangdong, 518000, China; State Key Laboratory of Chemical Oncogenomics, Tsinghua Shenzhen International Graduate School, Shenzhen, 518055, China.
| | - Xumu Zhang
- Department of Chemistry, College of Science, Academy for Advanced Interdisciplinary Studies and Medi-X Pingshan, Southern University of Science and Technology, Shenzhen, Guangdong, 518000, China.
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Azh N, Barzkar F, Motamed‐Gorji N, Pourvali‐Talatappeh P, Moradi Y, Vesal Azad R, Ranjbar M, Baradaran H. Nonsteroidal anti-inflammatory drugs in acute viral respiratory tract infections: An updated systematic review. Pharmacol Res Perspect 2022; 10:e00925. [PMID: 35218614 PMCID: PMC8881905 DOI: 10.1002/prp2.925] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 12/26/2021] [Accepted: 01/17/2022] [Indexed: 01/08/2023] Open
Abstract
In this systematic review, we aimed to assess the efficacy and safety of nonsteroidal anti-inflammatory drugs (NSAIDs) in treating respiratory tract infections in adults and children. PubMed, Scopus, Web of Science, Cochrane, and Embase databases were searched. A total of 34 randomized clinical trials were included in this systematic review. We assessed the risk of bias of all included studies using the Cochrane tool for risk of bias assessment. The evidence on ibuprofen, naproxen, aspirin, diclofenac, and other NSAIDs were rated for degree of uncertainty for each of the study outcomes and summarized using the grading of recommendations assessment, development, and evaluation (GRADE) approach. Our findings suggest that high-quality evidence supports the use of NSAIDs to reduce fever in both adults and children. However, the evidence was uncertain for the use of NSAIDs to reduce cough. Most studies showed that NSAIDs significantly relieved sore throat. The evidence for mortality and oxygenation is limited. Regarding the adverse events, gastrointestinal discomfort was more frequently reported in children. For adults, our overall certainty in effect estimates was low and the increase in gastrointestinal adverse events was not clinically significant. In conclusion, NSAIDs seem to be beneficial in the outpatient management of fever and sore throat in adults and children. Although the evidence does not support their use to decrease mortality nor improve oxygenation in inpatient settings, the use of NSAIDs did not increase the rate of death or the need for ventilation in patients with respiratory tract infections. Further studies with a robust methodology and larger sample sizes are recommended.
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Affiliation(s)
- Nima Azh
- School of MedicineIran University of Medical SciencesTehranIran
| | - Farzaneh Barzkar
- Center for Educational Research in Medical SciencesIran University of Medical SciencesTehranIran
| | | | | | - Yousef Moradi
- Social Determinants of Health Research CenterResearch Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Roya Vesal Azad
- School of Public HealthIran University of Medical SciencesTehranIran
| | - Mitra Ranjbar
- Department of Infectious DiseasesSchool of MedicineIran University of Medical ScienceTehranIran
| | - Hamid Reza Baradaran
- Ageing Clinical and Experimental Research TeamInstitute of Applied Health SciencesSchool of MedicineMedical SciencesNutrition University of AberdeenAberdeenUK
- Department of EpidemiologySchool of Public HealthIran University of Medical SciencesTehranIran
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Jung SY, Song SY, Kim E. Trends in Ambulatory Analgesic Usage after Myocardial Infarction: A Nationwide Cross-Sectional Study of Real-World Data. Healthcare (Basel) 2022; 10:446. [PMID: 35326923 PMCID: PMC8956017 DOI: 10.3390/healthcare10030446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 02/01/2023] Open
Abstract
Although current guidelines for myocardial infarction (MI) recommend caution in using non-steroidal anti-inflammatory drugs (NSAIDs), real-world studies of ambulatory settings are rare. This study aimed to explore the patterns and trends of analgesic prescriptions (especially NSAIDs) among patients with a history of MI in ambulatory care settings in Korea. We analyzed real-world data from the Korea National Health Insurance Service database. Patients aged 20 years or older hospitalized with incident MI were identified between January 2007 and December 2015. Ambulatory analgesics were administered after discharge from incident hospitalization for MI, and annual trends in the prescriptions of individual analgesics were evaluated. Among the 93,597 patients with incident MI, 75,131 (80.3%) received a total of 2,081,705 ambulatory analgesic prescriptions. Prescriptions were mainly issued at primary care clinics (80.3%). Analgesics were most frequently prescribed for musculoskeletal diseases (often NSAIDs, 70.7%); aceclofenac (13.7%) and diclofenac injection (9.4%) were the frequently used NSAIDs. Additionally, significant changes were observed in the trends for some analgesics, such as loxoprofen. This study suggested that NSAIDs are commonly prescribed to patients with a history of MI. Future real-world studies are needed to elucidate the drug-disease interactions of NSAIDs prescribed after MI, especially for patients with musculoskeletal diseases.
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Affiliation(s)
- Sun-Young Jung
- College of Pharmacy, Chung-Ang University, Seoul 06974, Korea;
| | - Seung Yeon Song
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea;
| | - Eunyoung Kim
- College of Pharmacy, Chung-Ang University, Seoul 06974, Korea;
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea;
- Department of Pharmaceutical Industry, Graduate School, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
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De Sutter AI, Eriksson L, van Driel ML. Oral antihistamine-decongestant-analgesic combinations for the common cold. Cochrane Database Syst Rev 2022; 1:CD004976. [PMID: 35060618 PMCID: PMC8780136 DOI: 10.1002/14651858.cd004976.pub4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Although combination formulas containing antihistamines, decongestants, and/or analgesics are sold over-the-counter in large quantities for the common cold, the evidence for their effectiveness is limited. This is an update of a review first published in 2012. OBJECTIVES To assess the effectiveness of antihistamine-decongestant-analgesic combinations compared with placebo or other active controls (excluding antibiotics) in reducing the duration of symptoms and alleviating symptoms (general feeling of illness, nasal congestion, rhinorrhoea, sneezing, and cough) in children and adults with the common cold. SEARCH METHODS We searched CENTRAL, MEDLINE via EBSCOhost, Embase, CINAHL via EBSCOhost, LILACS, and Web of Science to 10 June 2021. We searched the WHO ICTRP and ClinicalTrials.gov on 10 June 2021. SELECTION CRITERIA Randomised controlled trials investigating the effectiveness of antihistamine-decongestant-analgesic combinations compared with placebo, other active treatment (excluding antibiotics), or no treatment in children and adults with the common cold. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. We assessed the certainty of the evidence using the GRADE approach. We categorised the included trials according to the active ingredients. MAIN RESULTS We identified 30 studies (6304 participants) including 31 treatment comparisons. The control intervention was placebo in 26 trials and an active substance (paracetamol, chlorphenindione + phenylpropanolamine + belladonna, diphenhydramine) in six trials (two trials had placebo as well as active treatment arms). Reporting of methods was generally poor, and there were large differences in study design, participants, interventions, and outcomes. Most of the included trials involved adult participants. Children were included in nine trials. Three trials included very young children (from six months to five years), and five trials included children aged 2 to 16. One trial included adults and children aged 12 years or older. The trials took place in different settings: university clinics, paediatric departments, family medicine departments, and general practice surgeries. Antihistamine-decongestant: 14 trials (1298 participants). Eight trials reported on global effectiveness, of which six studies were pooled (281 participants on active treatment and 284 participants on placebo). The odds ratio (OR) of treatment failure was 0.31 (95% confidence interval (CI) 0.20 to 0.48; moderate certainty evidence); number needed to treat for an additional beneficial outcome (NNTB) 3.9 (95% CI 3.03 to 5.2). On the final evaluation day (follow-up: 3 to 10 days), 55% of participants in the placebo group had a favourable response compared to 70% on active treatment. Of the two trials not pooled, one showed some global effect, whilst the other showed no effect. Adverse effects: the antihistamine-decongestant group experienced more adverse effects than the control group: 128/419 (31%) versus 100/423 (13%) participants suffered one or more adverse effects (OR 1.58, 95%CI 0.78 to 3.21; moderate certainty of evidence). Antihistamine-analgesic: four trials (1608 participants). Two trials reported on global effectiveness; data from one trial were presented (290 participants on active treatment and 292 participants on ascorbic acid). The OR of treatment failure was 0.33 (95% CI 0.23 to 0.46; moderate certainty evidence); NNTB 6.67 (95% CI 4.76 to 12.5). Forty-three per cent of participants in the control group and 70% in the active treatment group were cured after six days of treatment. The second trial also showed an effect in favour of the active treatment. Adverse effects: there were not significantly more adverse effects in the active treatment group compared to placebo (drowsiness, hypersomnia, sleepiness 10/152 versus 4/120; OR 1.64 (95 % CI 0.48 to 5.59; low certainty evidence). Analgesic-decongestant: seven trials (2575 participants). One trial reported on global effectiveness: 73% of participants in the analgesic-decongestant group reported a benefit compared with 52% in the control group (paracetamol) (OR of treatment failure 0.28, 95% CI 0.15 to 0.52; moderate certainty evidence; NNTB 4.7). Adverse effects: the decongestant-analgesic group experienced significantly more adverse effects than the control group (199/1122 versus 75/675; OR 1.62 95% CI 1.18 to 2.23; high certainty evidence; number needed to treat for an additional harmful outcome (NNTH 17). Antihistamine-analgesic-decongestant: six trials (1014 participants). Five trials reported on global effectiveness, of which two studies in adults could be pooled: global effect reported with active treatment (52%) and placebo (34%) was equivalent to a difference of less than one point on a four- or five-point scale; the OR of treatment failure was 0.47 (95% CI 0.33 to 0.67; low certainty evidence); NNTB 5.6 (95% CI 3.8 to 10.2). One trial in children aged 2 to 12 years, and two trials in adults found no beneficial effect. Adverse effects: in one trial 5/224 (2%) suffered adverse effects with the active treatment versus 9/208 (4%) with placebo. Two other trials reported no differences between treatment groups. AUTHORS' CONCLUSIONS We found a lack of data on the effectiveness of antihistamine-analgesic-decongestant combinations for the common cold. Based on these scarce data, the effect on individual symptoms is probably too small to be clinically relevant. The current evidence suggests that antihistamine-analgesic-decongestant combinations have some general benefit in adults and older children. These benefits must be weighed against the risk of adverse effects. There is no evidence of effectiveness in young children. In 2005, the US Food and Drug Administration issued a warning about adverse effects associated with the use of over-the-counter nasal preparations containing phenylpropanolamine.
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Affiliation(s)
- An Im De Sutter
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Lars Eriksson
- Herston Health Sciences Library, The University of Queensland, Brisbane, Australia
| | - Mieke L van Driel
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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Nosulya EV, Kunelskaya VY, Kim IA, Yushkina MA. [The effectiveness of complex drugs in the treatment of acute rhinitis]. Vestn Otorinolaringol 2021; 86:82-86. [PMID: 34964335 DOI: 10.17116/otorino20218606182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose of the study. Generalization of data on the value of alternative and additional treatment of acute infectious rhinitis with Korizalia. MATERIAL AND METHODS The material of scientific publications included in the Cochrane Library, information bases of the RSCI, MEDLINE, PubMed was used as a data source. The choice of material was carried out using the key words: colds, acute rhinitis, herbal medicine, homeopathic remedies. RESULTS Analysis of published clinical trial descriptions suggests the potential value of homeopathic medicines, in particular Korizalia, in improving the effectiveness of the treatment of acute rhinitis. The use of Korizalia in acute infectious rhinitis was more effective in relation to the main symptoms of ARI compared with placebo. CONCLUSION The lack of optimal drugs for the etiotropic treatment of viral acute respiratory infections determines the relevance of alternative and complementary methods of treatment using drugs of natural origin. The drug Korizalia can be used for acute respiratory infections (acute infectious rhinitis) as an alternative drug or in combination with other drugs.
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Affiliation(s)
- E V Nosulya
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - V Ya Kunelskaya
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - I A Kim
- National Medical Research Center of Otorhinolaryngology of the Federal Medical and Biological Agency, Moscow, Russia.,Pirogov Russian National Research Medical University, Moscow, Russia
| | - M A Yushkina
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia.,Pirogov Russian National Research Medical University, Moscow, Russia
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Pietrusiewicz M, Kopa-Stojak PN, Pawliczak R. Pharmacist's recommendations of over-the-counter treatments for the common cold - analysis of prospective cases in Poland. BMC FAMILY PRACTICE 2021; 22:216. [PMID: 34717562 PMCID: PMC8556806 DOI: 10.1186/s12875-021-01561-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 10/11/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Common cold is a frequent illness in northern hemisphere between late autumn and early spring. Patients suffering from it frequently turn to pharmacists instead of physicians in order to receive medical advice and treatment. We studied its treatment advised by pharmacists in Poland, as well as evidence for the efficacy of their recommendations by utilizing a self-developed questionnaire and a study of existing literature. METHODS The data were collected by 27 pharmacists who worked in four large network community pharmacies in Lodz, Poland. The study took place from December 2019 to February 2020. Data were recorded only if the patient asked for pharmacy counselling for over-the counter (OTC) products due to common cold self-diagnosis and a product was sold. Pharmacists' recommendations were compared with the results of a literature review of best evidence to determine appropriateness of the pharmacists' decisions. RESULTS In four out of five cases the pharmacists recommended products contained paracetamol. In addition, in one out of three patient encounters they advised nasal decongestant, inosines and/or OTC mucolytics. There was a significant relationship between fever and recommendation frequency of some analgesics, inosines, mucolytics and sore throat products (OR > 1, p < 0.05); rhinorrhea and recommendation frequency of paracetamol, inosines, anti-histamines and alpha-mimetics (OR > 1, p < 0.05); cough and recommendation frequency of paracetamol, inosines, mucolytics and sore throat products (OR > 1, p < 0.05); and fatigue and recommendation frequency of paracetamol, acetylsalicylic acid, inosines and sore throat products (OR > 1, p < 0.05). The pharmacist recommendations were based on patients' symptoms, product price, pharmaceutical company promotion and the financial incentive. In many cases their recommendations were not in line with current best practice recommendations. CONCLUSIONS Our study suggests that the most common rationale for pharmacist recommendation on anti-common cold treatment was to take a "shotgun" approach. Pharmacists commonly made recommendations for products that lack strong evidence for efficacy (i.e. anti-viral agents) and are potentially unnecessary, based on presentation of the symptom. Reasons for this situation include lack of training, lack of time to evaluate the patient, lack of awareness of evidence as well as drug company marketing and financial incentives (i.e. fulfilling sale plans and target sale bonuses). TRIAL REGISTRATION The study was a non-interventional, observational research trial. The study registration was not required.
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Affiliation(s)
| | | | - Rafal Pawliczak
- Department of Immunopathology, Faculty of Medicine, Medical University of Lodz, Lodz, Poland.
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Jiang M, Chen J, Ding Y, Gan C, Hou Y, Lei J, Wan M, Li X, Xiao Z. Efficacy and Safety of Sea Salt-Derived Physiological Saline Nasal Spray as Add-On Therapy in Patients with Acute Upper Respiratory Infection: A Multicenter Retrospective Cohort Study. Med Sci Monit 2021; 27:e929714. [PMID: 33974619 PMCID: PMC8122848 DOI: 10.12659/msm.929714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background The purpose of this study was to assess the effects of seawater on nasal congestion and runny nose symptoms in adults with an acute upper respiratory infection (URI). Material/Methods This was a multicenter retrospective cohort trial of patients with acute URI and symptoms of nasal congestion and runny nose. The patients were assigned to 2 groups and were administered regular non-drug supportive treatment or supportive treatment with nasal irrigation with sea salt-derived physiological saline. The primary efficacy endpoint was the effective rate (percentage of patients with ≥30% symptom score reduction from baseline for nasal congestion and runny nose). Results In total, 144 patients were enrolled, including 72 in each group, and 143 patients completed the study. Both groups had similar demographics and vital signs. The effective rates for nasal congestion and runny nose were significantly increased in the seawater group compared with patients in the control group (87.3% vs 59.7% for nasal congestion; 85.9% vs 61.1% for runny nose; both P<0.001). In addition, the 2 groups showed markedly different degrees of patient symptom score improvement in sleep quality and appetite (both P<0.01), but not in cough and fatigue (both P>0.05). There were no adverse events in either group. Conclusions The sea salt-derived physiological saline nasal spray device satisfactorily improved nasal congestion, runny nose, sleep quality, and appetite in adults with URI, with no adverse effects.
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Affiliation(s)
- Min Jiang
- Department of Respiratory and Critical Care Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Junwen Chen
- Department of Respiratory and Critical Care Medicine, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China (mainland)
| | - Yuanhua Ding
- Department of Respiratory Medicine, Taizhou Hospital of Traditional Chinese Medicine, Taizhou, Jiangsu, China (mainland)
| | - Chenxi Gan
- Office of Drug Clinical Trial Management, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Ya Hou
- Department of Biological Statistics, Jiangsu Famai Sheng Medical Science and Technology Co., Ltd., Zhenjiang, Jiangsu, China (mainland)
| | - Junge Lei
- Department of Respiratory and Critical Care Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Mengzhi Wan
- Department of Respiratory and Critical Care Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Xing Li
- Department of Respiratory and Critical Care Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Zuke Xiao
- Department of Respiratory and Critical Care Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, China (mainland)
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Mahendran SA. Use of fever detection in combination with thoracic ultrasonography to identify respiratory disease, and compare treatments of antimicrobials and NSAID: a randomised study in dairy calves. Vet Rec Open 2020; 7:e000415. [PMID: 33194211 PMCID: PMC7643518 DOI: 10.1136/vetreco-2020-000415] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/29/2020] [Accepted: 10/06/2020] [Indexed: 11/13/2022] Open
Abstract
Background This study explored the combined use of fever detection and thoracic ultrasonography to identify calves with early onset bovine respiratory disease (BRD). Thoracic ultrasonography was then used to assess the efficacy of antimicrobial and non-steroidal anti-inflammatory drug (NSAID) treatment for early onset BRD through a randomised study design. Methods Calves were recruited from a single dairy farm in the UK, and fitted with a TempVerified FeverTag, which was activated when a calf developed fever (a temperature of 39.7°C for six hours). On identification of fever, a Wisconsin calf score was used to provide a diagnosis of BRD by exclusion of other causes. Calves were randomly assigned to experimental groups; group 1 (NSAID) received flunixin meglumine, group 2 (antimicrobial) received florfenicol, group 3 (both) received both drugs. A thoracic ultrasound was conducted within 48 hours of fever detection, and again 14 days later to assess lung pathology. Results A total of 152 calves were recruited, with a relative BRD prevalence of 49 per cent (74/152). Thirty-two calves required a secondary treatment (due to continued fever), causing exclusion from statistical analysis of the change in ultrasound score and resulting in the study being underpowered for detecting statistical significance. Initial thoracic ultrasound scores were very low, with 70/74 calves scoring either 0 or 1, indicating few comet tails and no lung consolidation was seen and potential overdiagnosis of BRD. For assessment of therapy efficacy, no effect of experimental group was detected on average daily growth rates (mean 0.85 kg/day, P=0.89). Calves also displayed very few clinical signs at the time of fever detection. These factors combined suggest a high rate of false positive identification (low specificity) for BRD through fever detection alone. Calves given the NSAID only were more likely to require repeat treatments due to fever recurrence (OR=3.10 (95 per cent CI 0.86 to 11.15), P=0.083). Also calves affected by their first case of fever at an older age (21 v 28 days old) were less likely to go on to have further fever episodes (OR=0.95 (95 per cent CI 0.90 to 0.99), P=0.026). Conclusion This study demonstrated calves given only an NSAID at occurrence of fever due to BRD may be more likely to require repeat treatments throughout the preweaning period. The use of fever detection alone for BRD indicated a low specificity for definitive diagnosis as shown by the low thoracic ultrasound scores and lack of clinical signs. The study was underpowered to assess the ultrasonic effects of the different treatment protocols on lung pathology.
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11
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Karateev AE, Nasonov EL, Lila AM. DO NSAIDS CAUSE SPECIFIC COMPLICATIONS IN COVID-19 CORONAVIRUS INFECTION? RHEUMATOLOGY SCIENCE AND PRACTICE 2020. [DOI: 10.14412/1995-4484-2020-340-343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Currently, there is no clear data indicating the risk of specific complications when using non-steroidal anti-inflammatory drugs (NSAIDs), and in particular ibuprofen, for COVID-19 infection. There is also no clear clinical evidence that taking NSAIDs increases the risk of COVID-19 infection. However, when using NSAIDs in patients with acute respiratory viral diseases, keep in mind the possibility of class-specific complications from the gastrointestinal tract, cardiovascular system and kidneys. This risk is quite serious in elderly patients with multiple comorbid diseases. In addition, you should remember that taking NSAIDs and paracetamol can mask important symptoms of COVID-19 infection (in particular, fever) and lengthen the time for making a correct diagnosis.
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Affiliation(s)
| | - E. L. Nasonov
- V.A. Nasonova Research Institute of Rheumatology; I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | - A. M. Lila
- V.A. Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
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12
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Kim KI, Hong M, Park YC, Lee BJ, Kim K, Kang BK, Choi JY. Herbal medicines (Eunkyosan and Samsoeum) for treating the common cold: a protocol for a randomized, placebo-controlled, multicenter clinical trial. Integr Med Res 2020; 9:48-53. [PMID: 32071868 PMCID: PMC7016249 DOI: 10.1016/j.imr.2020.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 01/13/2020] [Accepted: 01/13/2020] [Indexed: 11/16/2022] Open
Abstract
Background The common cold is the most frequent acute respiratory illness that places a burden on society, both personally and economically. There is no standard therapy; only symptomatic therapy remains the mainstay of common cold treatment. Thus, interest in herbal medicines is on the rise. Eunkyosan and Samsoeum are used for the common cold in East Asian countries. Although Eunkyosan and Samsoeum are clinically used for the treatment of the common cold, their effectiveness and safety have yet to be studied. Therefore, we aimed to evaluate their effectiveness and safety. Methods This study is a randomized, patient-assessor blind, controlled, parallel, and multicenter clinical trial. A total of 375 participants diagnosed with the common cold will be enrolled via four hospitals. The common cold patients will take a daily dose of Eunkyosan or Samsoeum or a placebo, three times a day for eight days. The primary outcome is the change in total Wisconsin Upper Respiratory Symptom Scale-21-Korean version (WURSS-21-K) score between baseline and six days. The secondary outcome includes the visual analogue scale (VAS). Safety is evaluated and adverse events are assessed throughout the trial. Written informed consent will be obtained from all study participants before enrollment. Discussion This results will be published in a peer-reviewed journal and disseminated in related conferences. Trial Registration ClinicalTrials. gov, registration number: NCT04073511.
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Affiliation(s)
- Kwan-Il Kim
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University, Republic of Korea
| | - Minna Hong
- Korean Medicine Hospital of Pusan National University, Republic of Korea
| | - Yang-Chun Park
- Department of Internal Medicine, College of Korean Medicine, Daejeon University, Republic of Korea
| | - Beom-Joon Lee
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University, Republic of Korea
| | - Kitae Kim
- Department of Korean Medicine, Semyung University, Republic of Korea
| | - Byung Kab Kang
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jun-Yong Choi
- Korean Medicine Hospital of Pusan National University, Republic of Korea.,School of Korean Medicine, Pusan National University, Republic of Korea
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13
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Parnham MJ, Geisslinger G. Pharmacological plasticity-How do you hit a moving target? Pharmacol Res Perspect 2019; 7:e00532. [PMID: 31768257 PMCID: PMC6868654 DOI: 10.1002/prp2.532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 09/19/2019] [Accepted: 09/21/2019] [Indexed: 12/23/2022] Open
Abstract
Paul Ehrlich's concept of the magic bullet, by which a single drug induces pharmacological effects by interacting with a single receptor has been a strong driving force in pharmacology for a century. It is continually thwarted, though, by the fact that the treated organism is highly dynamic and the target molecule(s) is (are) never static. In this article, we address some of the factors that modify and cause the mobility and plasticity of drug targets and their interactions with ligands and discuss how these can lead to unexpected (lack of) effects of drugs. These factors include genetic, epigenetic, and phenotypic variability, cellular plasticity, chronobiological rhythms, time, age and disease resolution, sex, drug metabolism, and distribution. We emphasize four existing approaches that can be taken, either singly or in combination, to try to minimize effects of pharmacological plasticity. These are firstly, to enhance specificity using target conditions close to those in diseases, secondly, by simultaneously or thirdly, sequentially aiming at multiple targets, and fourthly, in synchronization with concurrent dietary, psychological, training, and biorhythm-synchronizing procedures to optimize drug therapy.
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Affiliation(s)
- Michael J. Parnham
- Fraunhofer Institute for Molecular Biology & Applied Ecology IMEBranch for Translational Medicine and Pharmacology TMPFrankfurt am MainGermany
| | - Gerd Geisslinger
- Fraunhofer Institute for Molecular Biology & Applied Ecology IMEBranch for Translational Medicine and Pharmacology TMPFrankfurt am MainGermany
- Institute of Clinical PharmacologyJ.W. Goethe UniversityFrankfurtGermany
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14
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Piroulas C, Devillers L, Souty C, Sicsic J, Boisnault P, François M. Non-steroids anti-inflammatory drugs and risk of peritonsillar abscess in pharyngitis: a French longitudinal study in primary care†. Fam Pract 2019; 36:425-430. [PMID: 30423110 DOI: 10.1093/fampra/cmy111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The safety of non-steroids anti-inflammatory drugs (NSAIDs) in the context of pharyngitis is doubtful with contradictory results in the literature. OBJECTIVE To evaluate the risk of peritonsillar abscess (PTA) associated to NSAIDs consumption during a pharyngitis episode observed in primary care. METHOD A retrospective cohort study using Observatory of General Medicine Datalink from 1995 to 2010. All patients consulting a GP from the Datalink network for pharyngitis have been included. The occurrence of a PTA in the 15 days following the consultation for pharyngitis was matched. The association between PTA and prescriptions of NSAIDs was studied via an adjusted logistic regression model. RESULTS During the study period, 105 802 cases of pharyngitis and 48 cases of PTA following a pharyngitis were reported, concerning respectively 67 765 and 47 patients. In the multivariate analysis, the risk of PTA was associated positively with a NSAIDs prescription (OR = 2.9, 95% CI = 1.6-5.2). Other factors associated with PTA occurrence were the prescription of corticosteroids (OR = 3.1, 95% CI = 1.3-7.6) and an age between 20 and 40 years (OR = 5.7, 95% CI = 2.5-13.0). The prescription of antibiotics was not significantly associated with PTA (P = 0.7). CONCLUSION Prescription of NSAIDs in pharyngitis may increase the risk of PTA. This study encourages considering cautiously the balance between benefits and harms before prescription of NSAIDs for pharyngitis.
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Affiliation(s)
- Cedric Piroulas
- Département de médecine générale, UFR des sciences de la santé Simone Veil, Université Versailles-Saint-Quentin-en-Yvelines, Montigny le Bretonneux, France
| | - Louise Devillers
- Département de médecine générale, UFR des sciences de la santé Simone Veil, Université Versailles-Saint-Quentin-en-Yvelines, Montigny le Bretonneux, France
| | - Cecile Souty
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMR-S1136), Paris, France
| | - Jonathan Sicsic
- Université Paris Saclay, INSERM, Centre de Recherche en Epidémiologie et Santé des Populations, Villejuif cedex, France
| | - Philippe Boisnault
- Société Française de Médecine Générale (SFMG), Issy les Moulineaux, France
| | - Mathilde François
- Département de médecine générale, UFR des sciences de la santé Simone Veil, Université Versailles-Saint-Quentin-en-Yvelines, Montigny le Bretonneux, France.,Université Paris Saclay, INSERM, Centre de Recherche en Epidémiologie et Santé des Populations, Villejuif cedex, France
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15
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Voiriot G, Philippot Q, Elabbadi A, Elbim C, Chalumeau M, Fartoukh M. Risks Related to the Use of Non-Steroidal Anti-Inflammatory Drugs in Community-Acquired Pneumonia in Adult and Pediatric Patients. J Clin Med 2019; 8:E786. [PMID: 31163625 PMCID: PMC6617416 DOI: 10.3390/jcm8060786] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/22/2019] [Accepted: 05/27/2019] [Indexed: 12/22/2022] Open
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to alleviate symptoms during community-acquired pneumonia (CAP), while neither clinical data nor guidelines encourage this use. Experimental data suggest that NSAIDs impair neutrophil intrinsic functions, their recruitment to the inflammatory site, and the resolution of inflammatory processes after acute pulmonary bacterial challenge. During CAP, numerous observational data collected in hospitalized children, hospitalized adults, and adults admitted to intensive care units (ICUs) support a strong association between pre-hospital NSAID exposure and a delayed hospital referral, a delayed administration of antibiotic therapy, and the occurrence of pleuropulmonary complications, even in the only study that has accounted for a protopathic bias. Other endpoints have been described including a longer duration of antibiotic therapy and a greater hospital length of stay. In all adult series, patients exposed to NSAIDs were younger and had fewer comorbidities. The mechanisms by which NSAID use would entail a complicated course in pneumonia still remain uncertain. The temporal hypothesis and the immunological hypothesis are the two main emerging hypotheses. Current data strongly support an association between NSAID intake during the outpatient treatment of CAP and a complicated course. This should encourage experts and scientific societies to strongly advise against the use of NSAIDs in the management of lower respiratory tract infections.
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Affiliation(s)
- Guillaume Voiriot
- Assistance Publique-Hôpitaux de Paris, Service de Réanimation médico-chirurgicale, Hôpital Tenon, Hôpitaux Universitaires de l'Est Parisien, 75020 Paris, France.
- Sorbonne Université, UFR Médecine, 75006 Paris, France.
- Faculté de Médecine, GRC CARMAS, Université Paris Est, 94000 Créteil, France.
| | - Quentin Philippot
- Assistance Publique-Hôpitaux de Paris, Service de Réanimation médico-chirurgicale, Hôpital Tenon, Hôpitaux Universitaires de l'Est Parisien, 75020 Paris, France.
| | - Alexandre Elabbadi
- Assistance Publique-Hôpitaux de Paris, Service de Réanimation médico-chirurgicale, Hôpital Tenon, Hôpitaux Universitaires de l'Est Parisien, 75020 Paris, France.
| | - Carole Elbim
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, Team "Immune System, Neuroinflammation and Neurodegenerative Diseases", Hôpital Saint-Antoine, 75012 Paris, France.
| | - Martin Chalumeau
- UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Paris Descartes University, 75014 Paris, France.
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker hospital for Sick Children, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, 75015 Paris, France.
| | - Muriel Fartoukh
- Assistance Publique-Hôpitaux de Paris, Service de Réanimation médico-chirurgicale, Hôpital Tenon, Hôpitaux Universitaires de l'Est Parisien, 75020 Paris, France.
- Sorbonne Université, UFR Médecine, 75006 Paris, France.
- Faculté de Médecine, GRC CARMAS, Université Paris Est, 94000 Créteil, France.
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16
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van Driel ML, Scheire S, Deckx L, Gevaert P, De Sutter A. What treatments are effective for common cold in adults and children? BMJ 2018; 363:k3786. [PMID: 30305295 DOI: 10.1136/bmj.k3786] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
| | - Sophie Scheire
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Laura Deckx
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Philippe Gevaert
- Department of Ear, Nose and Throat, Ghent University, Ghent, Belgium
| | - An De Sutter
- Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium
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17
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Komagamine J. Characteristics of the use of cold combination products among older ambulatory patients at the National Hospital Organization Tochigi Medical Center in Japan: a retrospective single-center observational study. BMC Res Notes 2017; 10:728. [PMID: 29221489 PMCID: PMC5723061 DOI: 10.1186/s13104-017-3070-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 12/05/2017] [Indexed: 11/10/2022] Open
Abstract
Objective Results
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18
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Malesker MA, Callahan-Lyon P, Ireland B, Irwin RS. Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold: CHEST Expert Panel Report. Chest 2017; 152:1021-1037. [PMID: 28837801 PMCID: PMC6026258 DOI: 10.1016/j.chest.2017.08.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 06/26/2017] [Accepted: 08/05/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Acute cough associated with the common cold (CACC) causes significant impairment in quality of life. Effective treatment approaches are needed for CACC. We conducted a systematic review on the management of CACC to update the recommendations and suggestions of the CHEST 2006 guideline on this topic. METHODS This systematic review of randomized controlled trials (RCTs) asked the question: Is there evidence of clinically relevant treatment effects for pharmacologic or nonpharmacologic therapies in reducing the duration/severity of acute CACC? Studies of adults and pediatric patients with CACC were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on using the American College of Chest Physicians organization methodology. RESULTS Six systematic reviews and four primary studies identified from updated literature searches for each of the reviews or from hand searching were included and reported data on 6,496 participants with CACC who received one or more of a variety of interventions. The studies used an assortment of descriptors and assessments to identify CACC. CONCLUSIONS The evidence supporting the management of CACC is overall of low quality. This document provides treatment suggestions based on the best currently available evidence and identifies gaps in our knowledge and areas for future research.
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Affiliation(s)
- Mark A Malesker
- Pharmacy Practice Department, Creighton University, Omaha, NE.
| | | | | | - Richard S Irwin
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA
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