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Anti-histamines Cannot Be Recommended As A General Therapy For Non-specific Coughs In Children
Children with a cough that lasts more than 3-4 weeks and is not associated with an identifiable illness are sometimes given anti-histamines.
In adults with chronic cough, anti-histamines are recommended as an empirical treatment, but a systematic review of research failed to find evidence that it works for children. Anti-histamines do, however, have well known side-effects.
Balancing the small chance of benefit against the known risks, caused the researchers to conclude that; "antihistamines cannot be recommended as empirical therapy for children with chronic cough; very young children are particularly vulnerable to the adverse events."
There are two broad classes of anti-histamines - the first generation H1 receptor antagonists (eg. diphenhydramine, hydroxyzine, chlorpheniramine, brompheniramine and clemastine), and the second generation non sedating antihistamines (terfenadine, astemizole, loratadine and cetirizine). The first generation drugs are less specific in their action and tend to have more side-effects.
One study that the researchers looked at found that cetirizine did reduce coughing within 2 weeks of starting treatment.
"There is a surprising lack of high quality evidence in this area, given that millions of children around the world have chronic coughs each year," according to lead Review Author Associate Professor Anne Chang. "What we need are well designed randomised controlled trials of anti-histamines that are designed so that neither the child nor carers know which treatment is being given - this will help rule out any placebo effect that could confuse the results."