Dr. Ron’s Research Review – August 21, 2013

© 2013

This week’s research review focuses on honey and vapor rub for coughs in children.

Parents rated honey most favorably for symptomatic relief of their child's nocturnal cough and sleep difficulty due to upper respiratory tract infection. The study compared a single dose of buckwheat honey, honey-flavored dextromethorphan (DM), or no treatment administered 30 minutes prior to bedtime. Honey may be a preferable treatment for the cough and sleep difficulty associated with childhood upper respiratory tract infection. (Paul, Beiler et al. 2007)

Parents also rated vapor rub (VR) most favorably for symptomatic relief of their child's nocturnal cough, congestion, and sleep difficulty caused by upper respiratory tract infection. The study published in Pediatrics compared vapor rub, petrolatum, and no treatment in 138 children aged 2 to 11 years. Despite mild irritant adverse effects, VR provided symptomatic relief for children and allowed them and their parents to have a more restful night than those in the other study groups. (Paul, Beiler et al. 2010)

Dr. Ron


Articles

Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents

         (Paul, Beiler et al. 2007) Download

OBJECTIVES: To compare the effects of a single nocturnal dose of buckwheat honey or honey-flavored dextromethorphan (DM) with no treatment on nocturnal cough and sleep difficulty associated with childhood upper respiratory tract infections. DESIGN: A survey was administered to parents on 2 consecutive days, first on the day of presentation when no medication had been given the prior evening and then the next day when honey, honey-flavored DM, or no treatment had been given prior to bedtime according to a partially double-blinded randomization scheme. SETTING: A single, outpatient, general pediatric practice. PARTICIPANTS: One hundred five children aged 2 to 18 years with upper respiratory tract infections, nocturnal symptoms, and illness duration of 7 days or less. INTERVENTION: A single dose of buckwheat honey, honey-flavored DM, or no treatment administered 30 minutes prior to bedtime. MAIN OUTCOME MEASURES: Cough frequency, cough severity, bothersome nature of cough, and child and parent sleep quality. RESULTS: Significant differences in symptom improvement were detected between treatment groups, with honey consistently scoring the best and no treatment scoring the worst. In paired comparisons, honey was significantly superior to no treatment for cough frequency and the combined score, but DM was not better than no treatment for any outcome. Comparison of honey with DM revealed no significant differences. CONCLUSIONS: In a comparison of honey, DM, and no treatment, parents rated honey most favorably for symptomatic relief of their child's nocturnal cough and sleep difficulty due to upper respiratory tract infection. Honey may be a preferable treatment for the cough and sleep difficulty associated with childhood upper respiratory tract infection. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00127686.


Vapor rub, petrolatum, and no treatment for children with nocturnal cough and cold symptoms

         (Paul, Beiler et al. 2010) Download

OBJECTIVE: 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 upper respiratory tract infection. METHODS: Surveys were administered to parents on 2 consecutive days--on the day of presentation when no medication had been given the previous evening, and the next day when VR ointment, petrolatum ointment, or no treatment had been applied to their child's chest and neck before bedtime according to a partially double-blinded randomization scheme. RESULTS: There were 138 children aged 2 to 11 years who completed the trial. Within each study group, symptoms were improved on the second night. Between treatment groups, significant differences in improvement were detected for outcomes related to cough, congestion, and sleep difficulty; VR consistently scored the best, and no treatment scored the worst. Pairwise comparisons demonstrated the superiority of VR over no treatment for all outcomes except rhinorrhea and over petrolatum for cough severity, child and parent sleep difficulty, and combined symptom score. Petrolatum was not significantly better than no treatment for any outcome. Irritant adverse effects were more common among VR-treated participants. CONCLUSIONS: In a comparison of VR, petrolatum, and no treatment, parents rated VR most favorably for symptomatic relief of their child's nocturnal cough, congestion, and sleep difficulty caused by upper respiratory tract infection. Despite mild irritant adverse effects, VR provided symptomatic relief for children and allowed them and their parents to have a more restful night than those in the other study groups.


References

Paul, I. M., J. Beiler, et al. (2007). "Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents." Arch Pediatr Adolesc Med 161(12): 1140-6. [PMID: 18056558]

Paul, I. M., J. S. Beiler, et al. (2010). "Vapor rub, petrolatum, and no treatment for children with nocturnal cough and cold symptoms." Pediatrics 126(6): 1092-9. [PMID: 21059712]