Tuesday, March 23, 2010
Cough is the second most common reason that people see doctor's. So out of the myriad of reasons, cough is way up there. Is there any mysterious about this? It is very common and very annoying, so there is strong motivation for the many people who cough to go to the doctor.
I was asked by a desperate mom today about what to do for her child's cough. The child was 6-years-old and missing school for 3 days. The cough was continuous, but worse at night. The loud, seemingly non-stop, barking sound from coughing was keeping the family up at night. The parents had tried an over-the-counter cough suppressant medication, with no success. I determined the child had a bacterial sinus infection with thick, sticky post-nasal drip, producing this cough. I recommended an antibiotic, a decongestant, very warm saline rinses followed by saline gargles at least 4 times per day, and a 5 day course of oral steroids to reduce the inflammation of the respiratory tract (from the infection and the damage from coughing). His mom requested a narcotic cough suppressant, which I declined to give for the following reasons. Her son is coughing, from mucus that contains bacteria, which is entering his lungs. Suppressing his cough would allow this mucus to continue uninterrupted into his lungs. I do not think this would benefit him. It would allow the family to sleep better the next few nights, I understand this. The Food and Drug Administration actually concluded that codeine cough syrups were no more effective than dextromethorphan.
Next, his mother asked if she could give Rock'n Rye. This famous treatment is based on hearsay. There has never been a study that I am aware of or could find in medical literature. Rock'n Rye is bourbon that is 48 proof. I believe its effectiveness comes from the alcohol, which can cut through the thick mucus, hence removing some of the cause, and the sedating effects from alcohol putting the person to sleep. The effectiveness of other cough syrups like Nyquil and Cheracol I think is based on their alcohol content, which is 20 proof and 6 proof respectively. (The link goes to a very complete table of the alcohol content of over-the-counter medications.)
I did not recommend Rock'n Rye for her son. I did say she could give OTC Robitussin AC (7 proof) plus alternate giving him fairly warm chicken noodle soup and fairly warm mint tea with lemon and honey mixed in. Both help smoothe the throat and cut through the thick mucus. That's what I've read up and that's what I give my kids and myself for coughs.
I hope this story helped some readers understand cough treatments a little better,Your Allergy Dude.