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An observational study on cough in children: epidemiology, impact on quality of sleep and treatment outcome

Francesco De Blasio1*, Peter V Dicpinigaitis2, Bruce K Rubin3, Gianluca De Danieli4, Luigi Lanata4 and Alessando Zanasi5

Author Affiliations

1 Respiratory Medicine and Pulmonary Rehabilitation Section, Clinic Center, Private Hospital, Naples, Italy

2 Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA

3 Department of Pediatrics Virginia Commonwealth University Physician in Chief, Children's Hospital of Richmond, USA

4 Medical Department, Dompé spa, Milan, Italy

5 Pneumology Unit, University of Bologna, S.Orsola Malpighi Hospital, Bologna, Italy

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Cough 2012, 8:1  doi:10.1186/1745-9974-8-1

Published: 23 January 2012



Cough is one of the most frequent symptoms in children and is the most common symptom for which children visit a health care provider.


This is an observational study on acute cough associated with upper respiratory tract infection (URTI) in children. The study evaluates the epidemiology and impact of cough on quality of sleep and children's activities, and the outcome of cough with antitussive treatments in pediatric routine clinical practice. Study assessments were performed through a pediatric cough questionnaire (PCQ), developed by the Italian Society of Cough Study. A total of 433 children visited by family care pediatricians for acute cough due to a URTI were enrolled in this study, with mean age of 6.1 years (SD 3.6). Cough type, duration, severity and frequency, cough impact on sleep disturbances of children and parents and on school and sport activities were assessed at baseline. In a subset of 241 children who were either treated with antitussive drugs (levodropropizine n = 101, central antitussives n = 60) or received no treatment (n = 80), the outcome of cough after 6 days was analyzed in terms of resolution, improvement, no change, or worsening. Descriptive analysis, χ2 test, and multivariate analysis with stepwise logistic regression were performed.


Cough disturbed sleep in 88% of children and 72% of parents. In children treated with cough suppressants, the duration, type, intensity, and frequency cough were similar at baseline in the two groups respectively treated with levodropropizine and central antitussives (cloperastine and codeine). Both levodropropizine and central drugs reduced cough intensity and frequency. However, percentage of cough resolution was higher with levodropropizine than with central antitussives (47% vs. 28% respectively, p = 0.0012).


Acute cough disturbs sleep in most children and their parents. Both levodropropizine and central antitussives reduced cough intensity, with levodropropizine producing a higher cough resolution rate.

Cough; Antitussive; Children; Levodropropizine; Cloperastine; Codeine