title: Persistent nocturnal cough: randomised controlled trial of high dose inhaled corticosteroid.
abstract: OBJECTIVE
  To investigate the effect of a short course of inhaled corticosteroid in the treatment of isolated and persistent nocturnal cough in children.
  
  
  METHODS
  Randomised double blind placebo controlled study.
  
  
  METHODS
  Subjects' homes in east London, England.
  
  
  METHODS
  Consecutively referred children, 1-10 years old, with persistent nocturnal cough.
  
  
  METHODS
  Placebo or fluticasone propionate 1 mg twice daily for three nights and 500 microg twice daily for 11 nights. Videotaping of children at night: two nights' baseline, nights 3 and 4 after three days of inhaled corticosteroid, and nights 15 and 16.
  
  
  METHODS
  A fall in 75% of coughs from baseline.
  
  
  RESULTS
  50 subjects were recruited. The median number of coughs in the baseline period for the inhaled corticosteroid group and placebo group were 92 and 71, respectively (p = 0.43) and, on nights 15 and 16, 8 and 36, respectively (p < 0. 01). Compared to baseline, both groups of subjects improved significantly by nights 15 and 16 (p < 0.01; p < 0.01). Comparing the inhaled corticosteroid and placebo groups, coughs fell to a median of 22% and 57% of baseline totals on nights 3 and 4, respectively (p = 0.38), and 8% and 35% on nights 15 and 16, respectively (p = 0.02). 17 of 24 subjects on inhaled corticosteroid who completed the study and 8 of 23 on placebo improved by 75% after two weeks (p = 0.03).
  
  
  CONCLUSIONS
  Children with persistent nocturnal cough improve in two weeks after referral on placebo. There is a modest benefit from a two week course of high dose inhaled corticosteroid.
authors.affiliation: Queen Elizabeth Hospital for Children, Royal Hospitals Trust, Hackney Road, London E2 8PS, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Davies
authors.forename: P
authors.initials: P
authors.lastname: Fuller
authors.forename: A
authors.initials: A
authors.lastname: Picciotto
authors.forename: S A
authors.initials: SA
authors.lastname: McKenzie
mesh_terms: D000287:Administration, Topical; D000730:Androstadienes / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D002940:Circadian Rhythm; D003371:Cough / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D000068298:Fluticasone; D005500:Follow-Up Studies; D005938:Glucocorticoids; D006801:Humans; D007223:Infant; D008297:Male; D010349:Patient Compliance; D010865:Pilot Projects
chemical_list: D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D000068298:Fluticasone