Persistent nocturnal cough: randomised controlled trial of high dose inhaled corticosteroid.
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.
Davies
M J
MJ
Queen Elizabeth Hospital for Children, Royal Hospitals Trust, Hackney Road, London E2 8PS, UK.
Fuller
P
P
Picciotto
A
A
McKenzie
S A
SA
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
D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D000068298:Fluticasone