Fármacos de venta libre (FVL) para la tos aguda en niños y adultos en entornos comunitarios
Appendices
Appendix 1. MEDLINE search strategy
MEDLINE (OVID)
1 Cough/
2 cough*.mp.
3 1 or 2
4 exp Antitussive Agents/
5 exp Expectorants/
6 exp Cholinergic Antagonists/
7 exp Histamine H1 Antagonists/
8 exp Drug Combinations/
9 exp Nonprescription Drugs/
10 Self Medication/
11 (cough* adj5 (suppress* or mixtur* or medicin* or remed* or relief* or formula* or syrup* or medicat*)).tw.
12 (antituss* or expectorant* or anticholinerg* or antihistamin* or anti‐histamin* or mucolytic*).tw.
13 (over‐the‐counter or otc or nonprescrip* or nonprescrib* or non‐prescrip* or non‐prescrib*).tw.
14 (drug adj2 combination*).tw.
15 or/4‐14
16 3 and 15
Appendix 2. EMBASE.com search strategy
#26 #25 AND [embase]/lim AND [1‐3‐2010]/sd NOT [22‐3‐2012]/sd163
#25 #16 AND #24 952
#24 #19 NOT #23 693139
#23 #20 NOT #22 3418939
#22 #20 AND #21 723950
#21 'human'/de AND [embase]/lim 8050790
#20 'animal'/de OR 'nonhuman'/de OR 'animal experiment'/de AND [embase]/lim 4142889
#19 #17 OR #18 776450
#18 random*:ab,ti OR placebo*:ab,ti OR allocat*:ab,ti OR trial:ti OR crossover*:ab,ti OR 'cross‐over':ab,ti OR (doubl* NEXT/1 blind*):ab,ti AND [embase]/lim733748
#17 'randomized controlled trial'/de OR 'single blind procedure'/de OR 'double blind procedure'/de OR 'crossover procedure'/de AND [embase]/lim257879
#16 #3 AND #15 5100
#15 #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12 OR #13 OR #14188114
#14 (drug NEAR/2 combination*):ab,ti AND [embase]/lim9999
#13 'over‐the‐counter':ab,ti OR otc:ab,ti OR nonprescrip*:ab,ti OR nonprescrib*:ab,ti OR 'non‐prescription':ab,ti OR 'non‐prescribed':ab,ti AND [embase]/lim 8605
#12 antituss*:ab,ti OR expectorant*:ab,ti OR anticholinerg*:ab,ti OR antihistamin*:ab,ti OR 'anti‐histamine':ab,ti OR mucolytic*:ab,ti AND [embase]/lim 22936
#11 (cough* NEAR/5 (suppress* OR mixtur* OR medicin* OR remed* OR relief* OR formula* OR syrup* OR medicat*)):ab,ti AND [embase]/lim 1179
#10 'self medication'/de AND [embase]/lim 5809
#9 'non prescription drug'/de AND [embase]/lim 5821
#8 'drug combination'/de AND [embase]/lim 2554
#7 'histamine h1 receptor antagonist'/exp AND [embase]/lim 80640
#6 'cholinergic receptor blocking agent'/de AND [embase]/lim 17207
#5 'expectorant agent'/exp AND [embase]/lim 18166
#4 'antitussive agent'/exp AND [embase]/lim 68972
#3 #1 OR #2 52203
#2 cough*:ab,ti AND [embase]/lim 30822
#1 'coughing'/de OR 'irritative coughing'/de AND [embase]/lim 41121
Appendix 3. CINAHL (Ebsco) search strategy
S28 S16 and S26 Limiters ‐ Published Date from: 20100101‐20120331 20
S27 S16 and S26 103
S26 S17 or S18 or S19 or S20 or S21 or S22 or S23 or S24 or S25 172166
S25 (MH "Quantitative Studies") 7436
S24 TI placebo* OR AB placebo* 18646
S23 (MH "Placebos") 6225
S22 TI random* OR AB random* 91601
S21 (MH "Random Assignment") 27203
S20 TI ((singl* or doubl* or tripl* or trebl*) W1 (blind* or mask*)) OR AB ((singl* or doubl* or tripl* or trebl*) W1 (blind* or mask*)) 13567
S19 TI clinic* W1 trial* OR AB clinic* W1 trial* 25204
S18 PT clinical trial 49701
S17 (MH "Clinical Trials+") 101958
S16 S3 and S15 527
S15 S4 or S5 or S6 or S7 or S8 or S9 or S10 or S11 or S12 or S13 or S14 21889
S14 TI drug N2 combination* OR AB drug N2 combination* 732
S13 TI ( over‐the‐counter or otc or nonprescrip* or nonprescrib* or non‐prescrip* or non‐prescrib* ) OR AB ( over‐the‐counter or otc or nonprescrip* or nonprescrib* or non‐prescrip* or non‐prescrib* ) 2308
S12 TI ( antituss* or expectorant* or anticholinerg* or antihistamin* or anti‐histamin* or mucolytic* ) OR AB ( antituss* or expectorant* or anticholinerg* or antihistamin* or anti‐histamin* or mucolytic* ) 1695
S11 TI (cough* N5 (suppress* or mixtur* or medicin* or remed* or relief* or formula* or syrup* or medicat*) ) OR AB ( cough* N5 (suppress* or mixtur* or medicin* or remed* or relief* or formula* or syrup* or medicat*)) 279
S10 (MH "Self Medication") 690
S9 (MH "Drugs, Non‐Prescription") 2205
S8 (MH "Drug Combinations+") 9185
S7 (MH "Histamine H1 Antagonists+") 1749
S6 (MH "Cholinergic Antagonists+") 2423
S5 (MH "Expectorants+") 679
S4 (MH "Antitussive Agents+") 3355
S3 S1 or S2 4440
S2 TI cough* OR AB cough* 3755
S1 (MH "Cough") 2006
Appendix 4. LILACS (BIREME) search strategy
> Search > (MH:cough OR tos OR tosse OR cough$ OR MH:C08.618.248 OR MH:C23.888.852.293) AND (MH:"Antitussive Agents" OR MH:D27.505.954.427.153$ OR MH:D27.505.954.796.090$ OR Antitusígenos OR Antitussígenos OR antituss$ OR "Agentes Antitusígenos" OR "Agentes Antitusivos" OR Antitusivos OR "Fármacos Antitussivos" OR "Agentes Béquicos" OR "Substâncias Béquicas" OR "Medicamentos Béquicos" OR MH:Expectorants OR Expectorantes OR mucolytic$ OR MH:D27.505.954.796.250$ OR expectorant$ OR Mucolíticos OR MH:"Cholinergic Antagonists" OR "Antagonistas Colinérgicos" OR "Acetylcholine Antagonists" OR "Anticholinergic Agents" OR "Cholinergic‐Blocking Agents" OR Cholinolytics OR MH:D27.505.519.625.120.200$ OR MH:D27.505.696.577.120.200$ OR "Antagonistas de la Acetilcolina" OR "Agentes Anticolinérgicos" OR "Agentes Bloqueadores Colinérgicos" OR Colinolíticos OR MH:"Histamine H1 Antagonists" OR "Antagonistas de los Receptores Histamínicos H1" OR "Antagonistas dos Receptores Histamínicos H1" OR MH:D27.505.519.625.375.425.400$ OR MH:D27.505.696.577.375.425.400$ OR "Antihistamínicos Clásicos" OR "Antihistamínicos H1" OR "Antagonistas del Receptor H1 de Histamina" OR "Bloqueadores de los Receptores Histamínicos H1" OR "Bloqueadores de los Receptores H1 de Histamina" OR "Antihistaminas Clásicas" OR "Anti‐Histamínicos Clássicos" OR "Anti‐Histamínicos H1" OR "Antagonistas dos Receptores H1 de Histamina" OR "Bloqueadores dos Receptores Histamínicos H1" OR "Bloqueadores dos Receptores H1 de Histamina" OR "Anti‐Histaminas Clássicas" OR MH:"Drug Combinations" OR "Combinación de Medicamentos" OR "Combinação de Medicamentos" OR MH:"Multi‐Ingredient Cold, Flu, and Allergy Medications" OR "Medicamentos Compuestos contra Resfriado, Gripe y Alergia" OR "Medicamentos Compostos contra Resfriado, Influenza e Alergia" OR "Multi‐Ingredient Cold Medications" OR D26.310.500$ OR MH:"Nonprescription Drugs" OR "Medicamentos sin Prescripción" OR "Medicamentos sem Prescrição" OR "non‐prescription" OR nonprescription$ OR "over‐the‐counter" OR "behind‐the‐counter" OR otc OR "Medicamentos de Venta Libre" OR "Medicamentos de Libre Circulación" OR "Medicamentos não Prescritos" OR "Medicamentos de Venda Livre" OR "Medicamentos de Livre Circulação" OR "Medicamentos Isentos de Prescrição" OR MIPs OR MH:"Self Medication" OR Automedicación OR Automedicação OR anticholinerg$ OR antihistamin$) > clinical_trials
Appendix 5. Web of Science (Thomson Reuters) search strategy
# 968 #8 AND #7
Databases=SCI‐EXPANDED, SSCI, A&HCI, CPCI‐S, CPCI‐SSH, CCR‐EXPANDED,
IC Timespan=2010‐2012
Lemmatization=On
# 8197,325 Topic=(random* or placebo* or (clinic* NEAR/1 trial*) or
(doubl* NEAR/1 blind*) or (singl* NEAR/1 blind*)) OR Title=(trial)
Databases=SCI‐EXPANDED, SSCI, A&HCI, CPCI‐S, CPCI‐SSH, CCR‐EXPANDED,
IC Timespan=2010‐2012
Lemmatization=On
# 7299 #6 AND #1
Databases=SCI‐EXPANDED, SSCI, A&HCI, CPCI‐S, CPCI‐SSH, CCR‐EXPANDED,
IC Timespan=2010‐2012
Lemmatization=On
# 64,980 #5 OR #4 OR #3 OR #2
Databases=SCI‐EXPANDED, SSCI, A&HCI, CPCI‐S, CPCI‐SSH, CCR‐EXPANDED,
IC Timespan=2010‐2012
Lemmatization=On
# 5203
Topic=(cough* NEAR/5 (suppress* or mixtur* or medicin* or
remed* or relief* or formula* or syrup* or medicat*))
Databases=SCI‐EXPANDED, SSCI, A&HCI, CPCI‐S, CPCI‐SSH, CCR‐EXPANDED,
IC Timespan=2010‐2012
Lemmatization=On
# 42,027
Topic=(drug NEAR/2 combination*)
Databases=SCI‐EXPANDED, SSCI, A&HCI, CPCI‐S, CPCI‐SSH, CCR‐EXPANDED,
IC Timespan=2010‐2012
Lemmatization=On
# 31,197
Topic=(over‐the‐counter or otc or nonprescrip* or
nonprescrib* or non‐prescrip* or non‐prescrib*)
Databases=SCI‐EXPANDED, SSCI, A&HCI, CPCI‐S, CPCI‐SSH, CCR‐EXPANDED,
IC Timespan=2010‐2012
Lemmatization=On
# 21,680
Topic=(antituss* or expectorant* or anticholinerg* or
antihistamin* or anti‐histamin* or mucolytic*)
Databases=SCI‐EXPANDED, SSCI, A&HCI, CPCI‐S, CPCI‐SSH, CCR‐EXPANDED,
IC Timespan=2010‐2012
Lemmatization=On
# 13,195
Topic=(cough*)
Databases=SCI‐EXPANDED, SSCI, A&HCI, CPCI‐S, CPCI‐SSH, CCR‐EXPANDED,
IC Timespan=2010‐2012
Lemmatization=On
Appendix 6. Details of previous searches
This review was first published in 2001. We searched the Cochrane Controlled Trials Register (CENTRAL) (The Cochrane Library 2000, Issue 2), MEDLINE (January 1998 to December 1999), EMBASE (January 1998 to December 1999) and the UK Department of Health National Research Register (December 2000).
For the 2004 review update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2004, Issue 2), MEDLINE (January 1966 to June Week 3, 2004), EMBASE (January 1990 to March 2004) and the UK Department of Health National Research Register (December 2003).
For the 2007 review update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2006, Issue 4), MEDLINE (January 1966 to January Week 1, 2007), EMBASE (January 1990 to January 2007) and the UK Department of Health National Research Register (June 2007, http://www.update‐software.com/National/nrr‐frame.html).
For the 2010 update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 1), MEDLINE (January 1966 to March, week 2, 2010), EMBASE (January 1974 to March 2010) and the UK Department of Health National Research Register (March 2010, http://www.nihr.ac.uk/Pages/NRRArchive.aspx)
We used the following search strategy to search MEDLINE and CENTRAL. We combined the MEDLINE search with the Cochrane Highly Sensitive Search Strategy for identifying randomised trials in MEDLINE: sensitivity‐ and precision maximising version (2008 revision) Ovid format (Lefebvre 2011). The search string was modified slightly to search EMBASE.
MEDLINE (OVID)
1 exp COUGH/
2 cough$.mp.
3 or/1‐2
4 exp Antitussive Agents/
5 exp expectorants/
6 exp Cholinergic antagonists/
7 exp Histamine H1 Antagonists/
8 exp Drug Combinations/
9 exp Drugs, Non‐Prescription/
10 exp Self medication/
11 (antituss$ or expectorant$ or anticholinerg$ or antihistamin$ or (cough adj suppress$) or mucolytic$ or (drug adj combination$) or over‐the‐counter or OTC or non prescription).mp.
12 or/4‐11
13 3 AND 12
EMBASE.com
12. #8 AND #11
11. #9 OR #10
10. random*:ab,ti OR placebo*:ab,ti OR factorial*:ab,ti OR crossover*:ab,ti OR 'cross over':ab,ti OR 'cross‐over':ab,ti OR ((doubl* OR singl*) NEAR/2 (blind* OR mask)):ab,ti OR assign*:ab,ti OR allocat*:ab,ti OR volunteer*:ab,ti
9. 'single blind procedure'/exp OR 'double blind procedure'/exp OR 'crossover procedure'/exp OR 'randomized controlled trial'/exp
8. #3 AND #7
7. #4 OR #5 OR #6
6. 'cough suppressant':ab,ti OR 'cough suppressants':ab,ti OR 'drug combination':ab,ti OR 'drug combinations':ab,ti OR 'over the counter':ab,ti OR 'over‐the‐counter':ab,ti OR otc:ab,ti OR 'behind the counter':ab,ti OR 'behind‐the‐counter':ab,ti OR 'non prescription':ab,ti OR 'non‐prescription':ab,ti OR nonprescription:ab,ti
5. antituss*:ab,ti OR expectorant*:ab,ti OR anticholinerg*:ab,ti OR antihistamin*:ab,ti OR mucolytic*:ab,ti
4. 'antitussive agent'/exp OR 'expectorant agent'/exp OR 'cholinergic receptor blocking agent'/exp OR 'histamine h1 receptor antagonist'/exp OR 'drug combination'/exp OR 'behind the counter drug'/exp OR 'non prescription drug'/exp OR 'self medication'/exp
3. #1 OR #2
2. cough*:ab,ti
1. 'coughing'/de OR 'irritative coughing'/de
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
| Group | Study ID | Number participants | Treatment and duration | Outcome and result | Notes |
| 1. Antitussives | |||||
| Antitussives Adults | Adams | 108 | Moguisteine | Cough score (10‐point scale) | NS |
| Eccles | 81 | Codeine 4 days | 16‐item cough severity score | NS | |
| Freestone | 82 | Codeine Single dose | 5‐point symptom rating scale | NS | |
| Lee | 44 | Dextromethorphan Single dose | Cough severity score (3‐point scale) | NS | |
| Parvez | 451 | Dextromethorphan Single dose | Cough recordings at 180 minutes | Significant reduction in cough counts with treatment | |
| Pavesi | 710 | Dextromethorphan Single dose | Cough recordings at 180 minutes | Significant reduction in various cough measures with treatment | |
| Antitussives Children | Bhattacharya | 120 | Dextromethorphan | Composite 5‐item symptom score | NS |
| Korppi | 50 | Dextromethorphan 3 days | 4‐item cough symptoms score day 3 | NS | |
| Paul | 100 | Dextromethorphan Single dose | Composite 5‐item symptom score | NS | |
| Taylor | 57 | Dextromethorphan or codeine (3 arms) 3 nights | 4‐item symptom score | NS | |
| 2. Expectorants | |||||
| Expectorants Adults | Albrecht | 378 | Guaifenesin 1600 mg bd | 8‐item composite symptom score, day 4 | NS difference at day 7, reported day 4 outcomes |
| Kuhn | 65 | Guaifenesin 480 mg qid | Cough recordings and patient‐rated improvement in cough frequency and severity | NS | |
| Robinson | 239 | Guaifenesin 200 mg qid | Patient rating as 'helpful' | P value < 0.01 | |
| Expectorants Children | No studies | ||||
| 3. Mucolytics | |||||
| Mucolytics Adults | Nesswetha | 99 | Bromhexine 4 days | Cough frequency (cough every 2 to 4 minutes) Int 8.6% versus Con 15.2% | P value < 0.02 |
| Mucolytics Children | Nespoli | 40 | Letosteine | Composite symptom score | P value < 0.01 |
| 4. Antihistamine/decongestants | |||||
| Antihistamine/ decongestants Adults | Berkowitz | 283 | Loratadine and pseudoephedrine | 3‐item cough score | NS |
| Curley | 73 | Dexbrompheniramine and pseudoephedrine 7 days | 4‐item cough score | P value < 0.05 | |
| Antihistamine/ decongestants Children | Clemens | 59 | Brompheniramine and phenylpropanolamine 2 days | 7‐item cough scores | NS |
| Hutton | 96 | Brompheniramine and phenylephrine and propanolamine 2 days | 9‐item symptom score, % reported as improved | NS | |
| 5. Other combinations | |||||
| Other combinations Adults | Kurth | 113 | Dextromethorphan plus salbutamol 3 days | % improved day 3 | P value = 0.05 |
| Mizoguchi | 485 | Combination syrup | Cough score MD 0.42, day 2 | P value < 0.0001 | |
| Thackray | 70 | 'Vicks' | Patient preference Int 66% versus Con 27% | P value < 0.01 | |
| Tukiainen | 108 | Dextromethorphan with and without salbutamol 4 days | 5‐item symptom score MD 0.11 | NS | |
| Other combinations Children | Korppi | 51 | Dextromethorphan plus salbutamol 3 days | Cough symptoms MD 0.12, day 3 | NS |
| Reece | 43 | Combination syrups | Satisfactory antitussive response | NS | |
| 6. Antihistamines | |||||
| Antihistamines Adults | Berkowitz | 91 | Terfenadine 4 to 5 days | 3‐item symptom score MD 0.2 | NS |
| Gaffey | 250 | Terfenadine 3.5 days | Symptom score (scores not reported) | NS | |
| Antihistamines Children | Bhattacharya | 120 | Promethazine 3 days | 5‐item symptom score MD 0.3 | NS |
| Paul | 100 | Diphenhydramine Single dose | 5‐item symptom score | NS | |
| Sakchainanont | 143 | Clemastine and chlorpheniramine 3 days | 4‐item symptom score, % reporting improvement | NS | |
| 7. Honey | |||||
| Honey Adults | No studies | ||||
| Honey Children | Avner‐Cohen | 300 | 3 types honey (4 arms) | 5‐item composite symptom score | Significant symptom reductions in all honey groups compared to controls |
| Con: control | |||||
