Anti-histamines for prolonged non-specific cough in children

Children with non-specific cough are commonly treated with a variety of medications to treat the symptom of cough. The objective of this review was to evaluate the effectiveness of anti-histamines in children with prolonged cough that is not related to an underlying respiratory disease, that is, non-specific chronic cough. We included three therapeutic studies with 182 randomised participants. Two studies found that chronic cough significantly improved in both treatment and placebo groups with no difference between the two groups. One small study however described that children who had chronic cough associated with seasonal allergic rhinitis treated with cetirizine improved significantly more than children on placebo and this difference was evident by two weeks. Four studies that evaluated safety profiles included 3166 randomised participants and described a non significant increase in cough in participants who received the active medication. Despite the limitations of this review, our findings are similar to the review on anti-histamines for acute cough which showed no good evidence for or against the use of anti-histamines. In contrast to recommendations in adults with chronic cough, anti-histamines cannot be recommended as empirical therapy for children with chronic cough. Further research examining the effects of this treatment using child appropriate cough outcome measures is needed