Efficacy and safety of modified sequential three-step empirical therapy for chronic cough.
OBJECTIVE
Sequential three-step empirical therapy is useful for the management of chronic cough. The purpose of this study was to evaluate the efficacy and safety of modified sequential three-step empirical therapy.


METHODS
Consecutive patients (n = 240) with chronic cough were recruited and randomly assigned to receive modified (modified group) or primary (primary group) sequential three-step empirical therapy. The primary end-point was the overall rate of control of chronic cough. Secondary end-points were the rate of control of chronic cough at each step of therapy, the duration of treatment required, changes in cough symptom score, health-related quality of life and possible adverse effects.


RESULTS
The study was completed by 106 patients in the modified group and 108 patients in the primary group. The overall rate of control of chronic cough was 88.7% in the modified group and 91.7% in the primary group (chi(2) = 0.54, P > 0.05). There were no obvious differences in the rate of control of cough at each step of therapy, the duration of treatment required, patterns of cough symptom scores or improvements in the health-related quality of life between the modified and primary groups. However, the incidence of drowsiness was significantly lower in the modified group than in the primary group (11.7% vs 21.7%, chi(2) = 4.32, P = 0.04).


CONCLUSIONS
Modified three-step empirical therapy was as efficacious as primary three-step therapy for chronic cough, but was preferable because it had fewer side-effects.
Wei
Weili
W
Department of Respiratory Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
Yu
Li
L
Wang
Yu
Y
Li
Xin
X
Qiu
Zhihong
Z
Wang
Lan
L
Liu
Bo
B
Liang
Siwei
S
Lü
Hanjing
H
Qiu
Zhongmin
Z
D000328:Adult; D000628:Aminophylline / Q000009:adverse effects / Q000627:therapeutic use; D000996:Antitussive Agents / Q000627:therapeutic use; D019819:Budesonide / Q000009:adverse effects / Q000627:therapeutic use; D017332:Cetirizine / Q000009:adverse effects / Q000627:therapeutic use; D002744:Chlorpheniramine / Q000009:adverse effects / Q000627:therapeutic use; D002908:Chronic Disease; D003371:Cough / Q000188:drug therapy* / Q000209:etiology; D004294:Domperidone / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D036262:Empirical Research; D006801:Humans; D008694:Methamphetamine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D008875:Middle Aged; D009665:Noscapine / Q000009:adverse effects / Q000627:therapeutic use; D009853:Omeprazole / Q000009:adverse effects / Q000627:therapeutic use; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D011446:Prospective Studies; D011788:Quality of Life; D012894:Sleep Stages; D016896:Treatment Outcome
D000996:Antitussive Agents; D000628:Aminophylline; D002744:Chlorpheniramine; D008694:Methamphetamine; D019819:Budesonide; D004294:Domperidone; D009665:Noscapine; C005157:methoxyphenamine; D009853:Omeprazole; D011241:Prednisone; D017332:Cetirizine